A comparison of surgical techniques with regard to short-term complication rates in brachycephalic dogs: a multi-institutional retrospective study of 413 cases.

Objective: To compare short-term major complication rates among 4 staphylectomy techniques (cut-and-sew, CO2 laser, bipolar vessel-sealing device [BVSD], and BVSD with suture apposition [BVSD-SA]) in dogs with brachycephalic obstructive airway syndrome (BOAS).

Methods: A retrospective cohort of consecutive dogs that underwent staphylectomy for treatment of BOAS at 4 hospitals between 2012 and 2024 were identified. Dogs were excluded if they had concurrent illnesses likely to affect prognosis or a history of BOAS-related surgery. Dogs were grouped by surgical technique. Short-term major complications were analyzed in the entire population with multivariate logistic regression and between groups for significant associations.

Results: 413 dogs were included in this study. Short-term major complications occurred in 15.5% (64 of 413) of dogs, with an overall mortality rate of 7% (29 of 413). The major complication rates were 20.2% (19 of 94), 12.9% (13 of 101), 18.3% (19 of 104), and 11.4% (13 of 114) with cut-and-sew, CO2 laser, BVSD, and BVSD-SA, respectively. Cut-and-sew surgical technique had significantly greater risk for short-term major complication when compared to CO2 laser (OR, 2.9; 95% CI, 1.2 to 7.4) and BVSD-SA (OR, 3.0; 95% CI, 1.2 to 7.4) groupings. Increasing age (OR, 1.1; 95% CI, 1.0 to 1.3), body condition score (OR, 1.4; 95% CI, 1.1 to 1.8), needing an emergent procedure (OR, 3.8; 95% CI, 1.8 to 8), and higher-grade laryngeal collapse (OR, 3.1; 95% CI, 1.1 to 8.6) were all associated with major complication.

Conclusions: The cut-and-sew technique, increased age, higher body condition score, laryngeal collapse grade, and emergent staphylectomy were associated with higher short-term major complication rates.

Clinical Relevance: Avoidance of cut-and-sew technique may lower the risk of short-term major complications, particularly in dogs with additional risk factors for postoperative complications.