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3只犬大疱性肺气肿的胸腔镜治疗

Thoracoscopic treatment of bullous emphysema in 3 dogs.

作者信息

Brissot Herve N, Dupre Gilles P, Bouvy Bernard M, Paquet Laurent

机构信息

Clinique Fregis, Arcueil, France.

出版信息

Vet Surg. 2003 Nov-Dec;32(6):524-9. doi: 10.1111/j.1532-950x.2003.00524.x.

Abstract

OBJECTIVE

To report thorascopic partial lobectomy for treatment of bullous emphysema in dogs.

STUDY DESIGN

Prospective clinical study.

ANIMALS

Three dogs with spontaneous pneumothorax.

METHODS

Thoracoscopy without pulmonary exclusion was used to identify bulla. The thorascope was introduced into the thorax lateral to the xyphoid process, and instrument portals were made at different levels along the thoracic wall between the third and tenth intercostal spaces. The thorascope was passed through the mediastinum to view the opposite pleural cavity. After identification of bullae, the affected lung was excised using an endoscopic stapler, and the incision line was checked for air leakage. Thoracic drains were used for air aspiration for 2 days after surgery.

RESULTS

Bullae were confirmed histologically as emphysematous lesions. Lung inflation did not interfere with identification of bullae or with surgery. All dogs had full recovery without recurrence for 18 to 29 months after surgery.

CONCLUSIONS

Identification and ablation of bulla can be performed thoracoscopically without pulmonary exclusion in dogs.

CLINICAL RELEVANCE

Thoracoscopy offers several advantages compared with thoracotomy for treatment and diagnosis of idiopathic pneumothorax, including ease of identification of bullae and reduced postoperative pain and morbidity.

摘要

目的

报告胸腔镜下部分肺叶切除术治疗犬大疱性肺气肿。

研究设计

前瞻性临床研究。

动物

3只自发性气胸犬。

方法

采用不排除肺部的胸腔镜检查来识别肺大疱。将胸腔镜经剑突旁引入胸腔,在第三至第十肋间的胸壁不同水平制作器械通道。胸腔镜穿过纵隔以观察对侧胸膜腔。识别肺大疱后,使用内镜缝合器切除患肺,并检查切口线有无漏气。术后使用胸腔引流管进行2天的排气。

结果

组织学证实肺大疱为肺气肿性病变。肺膨胀不影响肺大疱的识别或手术操作。所有犬术后18至29个月均完全康复且无复发。

结论

犬可在不排除肺部的情况下通过胸腔镜识别并切除肺大疱。

临床意义

与开胸手术相比,胸腔镜在特发性气胸的治疗和诊断方面具有多个优势,包括易于识别肺大疱以及减轻术后疼痛和发病率。

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