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Often referred to as an R&A, esophageal resection and anastomosis is a procedure veterinarians perform in dogs to remove a section of the esophageal tract while keeping the remaining parts connected. Resection refers to the removal of the tissue, and anastomosis refers to the remaining tissue which is reconnected after the removal of affected or abnormal tissue. An esophageal resection and anastomosis is usually recommended if an endoscopy cannot clear a blockage or if there is clear evidence of tumors or cancer than needs to be removed with the tissue. This procedure can include a gastrointestinal resection and anastomosis and may involve any tissue from the esophagus to the rectum, removing any section in varying lengths from a minor few centimeters to much longer lengths depending on the affected tissue.
Your veterinarian may do a complete blood count (CBC) to help determine the cause of unhealthy cells and measure healthy cells in your pet’s blood. An X-ray may also be performed to determine the scope and reason for obstruction or stricture.
Because this is an invasive surgery, anesthesia will be required. Your veterinarian might perform an endoscopy first, depending on the cause of the stricture. If your dog has an esophageal tumor, this will not be required, but still, may be requested to explore the esophagus and determine the cause of the stricture. A less invasive endoscopy may be performed if the stricture is caused by an obstruction in the esophagus.
Depending on the nature of the stricture, an esophageal resection and anastomosis will be performed under anesthesia in which your veterinarian surgeon will remove the affected portion of the esophagus and suture the two ends back together.
Your veterinarian might keep your pet overnight or for a day or two to watch closely during recovery and will give you instructions for home care following the surgery.
Esophageal surgery is quite invasive and difficult in animals. If other options such as an endoscopy do not work as treatment, an esophageal resection and anastomosis might be necessary. Depending on the reasoning for the surgery, rates of success may vary. Cancer or tumors might be one reason to necessitate this surgery. Once the esophagus is cut and sutured back together with the affected tissue removed, the animal has a high rate of recovery. If cancer is found elsewhere, morbidity rates may be higher. If the reason for surgery is an obstruction or twisting of the esophagus, once removed, the success rate for the animal is high. If the same outcome can arise of a procedure such as an endoscopy, you may want to consider that as an option before invasive surgery. If your dog had a tumor removed in the resection surgery, this would be sent off for a biopsy to determine the tumor type.
Your veterinarian and staff will watch your dog very closely after surgery. They will be monitoring how well your dog is breathing on its own as they wake from the anesthesia. Your vet may prescribe anti-inflammatory medications as well as antibiotics to prevent infections. Pain medications will also be prescribed. They may keep your pet in the hospital for 24 to 48 hours to be monitored around the clock. Once your pet is home, it will be imperative to keep them calm and resting for up to a week. Soft foods or a liquid diet may be prescribed. It will be important to keep your animal hydrated during this time. They may be experiencing some pain, making eating and drinking difficult. Sutures will dissolve over time. Your veterinarian will want to recheck your dog after a week or two.
Depending on the scope and nature of the surgery, an esophageal resection and anastomosis could cost from $1,000 to $3,500. Other tests such as CBC, X-ray, and endoscopy may result in higher costs. An endoscopy alone might only cost between $1,000 and $1,800. If this is an option, it may be a better choice financially. If tumors are causing abnormal tissue, an endoscopy will be more of an exploratory procedure and not a surgical resolution.
Esophageal resection and anastomosis is highly invasive and a difficult surgery. It may be necessary and the only option if cancer is present within the esophagus. However, if the esophagus has an obstruction, there might be other options such as an endoscopy. Foreign objects can sometimes be removed with the help of an endoscope. If cancer is suspected, complete removal of affected tissue will give your pet the best chance of longer survival. By removing the tumor and affected tissue, the animal can potentially fully recover and lead a normal life. Preventing other obstructions along with a healthy lifestyle for your pet will give your pet the best chance of not facing this challenge again.
There are several factors to consider in why this surgery might be necessary. Chewing rawhide toys or ingesting other foreign objects can lead to esophageal obstruction in dogs. Choose safe treats and toys for dogs that are easier to digest and keep inappropriate objects away from your pet.
Watch your dog when they are eating meals. Bowls should be lifted higher for large breed dogs. The amount of food your pet ingests should be controlled. This might mean no open-feeding and scheduled meal times for your pet. Consider getting your pet a controlled feeding bowl to keep them from eating too quickly.
And, as always, a healthy diet recommended by your veterinarian with the proper portions and ratios of fat and proteins along with daily exercise will contribute to your pet’s overall health, giving them the best fight against tumors and cancer.
Visit with your veterinarian regularly and discuss your options based on the condition of your pet’s esophagus. Exploratory surgery through an endoscope can also retrieve a foreign object, solving some problems. However, be sure to check your pet’s home for other sources of objects and toys they should not be ingesting.
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