Radical surgical excision of extensive perianal melanomas on standing horses: Twenty cases.
Authors: Robert Mickaël P, Buyck Camille, Tricaud Cyril, Cousty Matthieu, Pujol Raymond
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Radical Surgical Excision of Extensive Perianal Melanomas in Standing Horses Perianal melanomas represent a significant clinical challenge in aged horses, yet options for radical removal of large tumours (≥4 cm) whilst maintaining standing surgery protocols remain underexplored. This retrospective analysis of 20 client-owned horses (median age 15 years) evaluated outcomes following extensive surgical excision under standing sedation with epidural anesthesia, including cases requiring full anal margin resection and deep perirectal dissection. Whilst the procedure proved technically feasible with encouraging long-term oncological control—only one of six new melanomas developed at the perianal site during median 11.8-month follow-up—early postoperative management proved demanding: 50% of hospitalized horses required manual rectal evacuation, and significant pain was routinely encountered despite additional local anesthetics in eight cases. Clinicians considering this approach should counsel owners about the substantial surgical wounds created and prepare for intensive postoperative care, including pain management and fecal output monitoring during the typical 6.5-day hospitalization period, recognising that most cases ultimately achieved uncomplicated healing within 6–12 weeks and demonstrated high client satisfaction with quality-of-life improvements.
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Practical Takeaways
- •Standing surgical excision is a viable option for large perianal melanomas in horses, offering good local control with minimal recurrence and high owner satisfaction
- •Expect significant postoperative pain management needs and rectal dysfunction in the immediate recovery period—manual evacuation may be necessary for multiple horses
- •Counsel owners that while local recurrence is low, new melanomas may develop elsewhere due to the systemic nature of the condition in affected horses
Key Findings
- •Radical surgical excision of extensive perianal melanomas was successfully performed in 20 standing horses under standing sedation and epidural anesthesia with median hospitalization of 6.5 days
- •Anal margin was fully resected in 14 cases and deep perirectal dissection performed in 16 cases, with only one case showing local recurrence during median 11.8-month follow-up
- •Early postoperative complications were common (50% required manual rectal evacuation, one horse euthanized due to ataxia, one had profuse hemorrhage) but late complications were minimal with wound healing in 6-12 weeks in most cases
- •Six horses developed new melanomas during follow-up (systemic disease), but only one was in the perianal region, indicating low local recurrence rate