Overview of Canine Gastrointestinal Resection & Anastomosis
Gastrointestinal resection and anastomosis, commonly abbreviated and referred to as an R & A, is a surgical procedure in which a section of the dog’s esophagus, stomach and/or intestinal tract is removed and the remaining parts are connected. The “resection” refers to the removal of the abnormal tissue and the “anastomosis” is the procedure where the two parts are reconnected.
This procedure may be performed at any point along the gastrointestinal tract from the esophagus to rectum, and the section removed can vary in length from a few centimeters to very long lengths.
What Are Indications for Gastrointestinal Resection & Anastomosis in Dogs?
Reasons for doing this procedure include:
Animals with these problems may display gastrointestinal symptoms such as vomiting, decreased appetite, weight loss, and/or diarrhea.
Resection and anastomosis is a commonly performed procedure. The success rate is relatively high, but depends on the underlying disease process and region of the gastrointestinal tract that is removed. The surgery can have serious complications if the affected animal does not heal well and the anastomosis comes apart or if a large majority of the intestinal tract is removed.
Diagnosis of Conditions Requiring Resection and Anastomosis in Dogs
Treatment with a Resection and Anastomosis in Dogs
Your dog will often be kept in the hospital for a few days for continued treatment and monitoring after a gastrointestinal resection and anastomosis has been performed. Once your dog is discharged from the hospital you will need to restrict his/her activity for several weeks. You will also need to monitor the skin incision for redness, swelling, or discharge.
Your dog may be sent home on a diet restricted in either volume or type of food fed and/or medications. Your veterinarian will typically ask you to return for a recheck appointment in two weeks so that he/she can monitor your dog’s progress and remove the skin sutures.
Information In-depth on Canine Gastrointestinal Resection & Anastomosis
Gastrointestinal resection and anastomosis is the name given to any surgical procedure in which a portion of the gastrointestinal tract is excised (resected) and the remaining ends of the tract are reattached (anastomosis).
Resection and anastomosis is most frequently done in the small intestines; however, resection and anastomosis of the stomach, colon (large intestines), or rectum is necessary with some diseases. Resection of a portion of the esophagus is less commonly performed.
Ingestion of a foreign body that subsequently becomes lodged in the small intestine is a common condition of dogs that requires resection and anastomosis. The obstruction can lead to necrosis or death of the wall of the intestine and ultimately to intestinal perforation. The entire length of damaged intestine is removed such that the two ends of the reattached intestine are healthy.
Another cause of obstruction is stricture, in which the walls of the esophagus or intestine constrict like a tightening ring, limiting the size of the lumen or opening. Stricture can be the result of previous injury by foreign objects, previous surgery, or tumors.
Intussusception is a condition in which a portion of the gastrointestinal tract advances into the intestine adjacent to it, similar to an old-fashioned telescope. If the intussusception cannot be undone, resection and anastomosis of the affected intestine may be necessary.
Torsion is the abnormal twisting of an organ that can cause disruption of its blood supply. Gastric dilatation/volvulus (GDV) is a condition where the stomach of dogs, typically large breeds, twists on itself. Depending on the duration and severity of the twist a portion of the stomach may be necrotic (unhealthy). If a large portion of stomach is severely damaged, resection and anastomosis may be necessary.
Mesenteric (intestinal) torsion is the twisting of the small intestines on its blood supply. This condition is almost always fatal; however, occasionally when surgery is done quickly a portion of the intestine may be salvageable. The necrotic (unhealthy) portion is removed and an anastomosis is performed.
Neoplasia (cancer) or benign tumors can occur in any region of the gastrointestinal tract. Fortunately the esophagus, which is difficult to operate on and is most prone to complications after surgery, is rarely involved. The stomach, small intestines, large intestines and rectum do develop tumors that may require resection and anastomosis to treat. The rectum is the portion of the colon that passes through the pelvic canal to the anus. It is accessed through an incision near the anus or under the pelvis (the floor of the pelvis must be split to access this area of the rectum).
Tumors of the stomach, small intestine and large intestine within the abdominal cavity are approached through an incision in the animal’s belly. Large tumors of the stomach can be difficult to remove with “clean” margins (lack of tumor cells at the cut edge of the removed tissue). The small and large intestine are much longer and usually allow for several centimeters of unaffected tissue to be excised to maximize the chance for complete tumor removal.
Depending on the underlying condition that requires that resection and anastomosis be performed, the prognosis is variable. For benign conditions (such as foreign body obstruction, intussusception, and benign tumors) the prognosis is generally excellent. If perforation of the gastrointestinal tract has occurred due to any cause the abdominal contents are usually inflamed (peritonitis) and anastomoses may not heal well. Thus, the presence of abdominal infection generally warrants a guarded prognosis. If the blood supply to a region of the gastrointestinal tract has been compromised, such as with torsion, the patient must be monitored closely after surgery because healing may be impaired. Some neoplastic conditions carry a poor prognosis because of possible recurrence, while others may be cured with surgery.