背景:支架已成为治疗犬气管塌陷的流行方法,但可能会出现并发症并对治疗结果产生负面影响.
目的:确定犬气管支架置入并发症的总体患病率。
方法:对2000年至2020年的出版物进行了书目检索。评估了狗气管支架置入后8种最常见并发症的证据质量和患病率(支架骨折,支架迁移,复发崩溃,肉芽肿形成,气管支气管感染,和早期,迟到,和临床相关的晚期咳嗽)。随机效应荟萃分析用于估计合并并发症的患病率。
结果:15项研究符合纳入标准。咳嗽(早期:99%;95%置信区间[95%CI]:95%-100%,晚:75%;95%CI:63%-85%,和临床相关:52%;95%CI:42%-61%),气管支气管感染(24%;95%CI:14%-35%),气管支架置入后常见肉芽肿(20%;95%CI:11%-30%)。支架骨折(12%;95%CI:5%-20%),复发性塌陷(10%;95%CI:5%-15%),和支架迁移(5%;95%CI:1%-9%)频率较低。支架骨折的估计患病率在研究中发现了显著的异质性,肉芽肿,感染,迟来的咳嗽。
结论:犬气管支架置入术与咳嗽的高风险以及气管支气管感染和肉芽肿形成的中等风险相关。因为大多数并发症会影响狗的生活质量,必须告知患者气管支架置入术是一种二线手术,不一定能减轻医疗和频繁随访的需要.需要进一步的研究来确定这些并发症的危险因素。
BACKGROUND: Stenting has become popular to treat tracheal collapse in dogs, but complications might arise and negatively affect treatment outcome.
OBJECTIVE: Determine the overall prevalence of complications of tracheal stenting in dogs.
METHODS: A bibliographic search was performed of publications from 2000 to 2020. Studies were assessed for quality of evidence and measured prevalence of the 8 most commonly reported complications after tracheal stenting in dogs (stent fracture, stent migration, relapsing collapse, granuloma formation, tracheobronchial infections, and early, late, and clinically relevant late cough). Random effects meta-analyses were used to estimate pooled complications prevalence.
RESULTS: Fifteen studies met inclusion criteria. Cough (early: 99%; 95% confidence interval [95% CI]: 95%-100%, late: 75%; 95% CI: 63%-85%, and clinically relevant: 52%; 95% CI: 42%-61%), tracheobronchial infections (24%; 95% CI: 14%-35%), and granulomas (20%; 95% CI: 11%-30%) were common after tracheal stenting. Stent fractures (12%; 95% CI: 5%-20%), relapsing collapse (10%; 95% CI: 5%-15%), and stent migration (5%; 95% CI: 1%-9%) were less frequent. Significant heterogeneity among studies was identified for the estimated prevalence of stent fracture, granulomas, infections, and late cough.
CONCLUSIONS: Tracheal stenting in dogs is associated with a high risk of coughing and a moderate risk of tracheobronchial infections and granuloma formation. Because most complications will impact a dog\'s quality of life, owners must be informed that tracheal stenting is a second-line procedure that does not necessarily alleviate the need for medical treatment and frequent follow-up visits. Additional studies are warranted to identify the risk factors of these complications.