Temporary end-on colostomy as a treatment for anastomotic dehiscence after a transanal rectal pull-through procedure in a dog

Objective To describe a temporary end-on colostomy to treat the dehiscence of a transanal rectal pull-through in a dog. Study design Case report Animal A 7-year-old intact female Australian shepherd dog that was treated for a rectal adenocarcinoma with a transanal rectal pull-through. Methods Partial dehiscence of the previous end-to-end colorectal anastomosis and formation of a perianal sinus tract were diagnosed 4 days after surgery. A pararectal approach was used to revise the surgery with debridement of the sinus tract, rectal wall reconstruction with single interrupted sutures, and placement of a passive drain. Dehiscence occurred 2 days later. The colon was transected cranial to the pelvic brim, and each stump was oversewn prior to salvage temporary end-on colostomy. Postoperative care included analgesia, antibiotic therapy, and local care of the perineal/perianal area and colostomy site. After 90 days, the perineal/perianal sinus tract had healed, the colostomy was eliminated, and an end-to-end anastomosis of the colon was performed. Results Management of postoperative complications focused on dermatitis of the stoma and perineal/perianal area, stoma incontinence, and perineal/perianal medications of the sinus tract. One year after the final surgery, the dog had occasional episodes of fecal incontinence and a good quality of life without other complications. Conclusion Use of a temporary end-on colostomy prior to revision surgery led to a satisfactory outcome but required long and challenging postoperative management. Clinical significance Temporary end-on colostomy may be an option to manage dehiscence and potential recurrent stenosis after transanal rectal pull-through in dogs.