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影响98只犬胸外科手术后短期预后的因素。

Factors influencing the short-term outcome following thoracic surgery in 98 dogs.

作者信息

Tattersall J A, Welsh E

机构信息

Division of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG.

出版信息

J Small Anim Pract. 2006 Dec;47(12):715-20. doi: 10.1111/j.1748-5827.2006.00080.x.

Abstract

OBJECTIVES

To evaluate the factors influencing the short-term (<14 days) outcome of thoracic surgery in dogs.

METHODS

A retrospective review of 98 dogs undergoing thoracotomy over a five-year period was undertaken.

RESULTS

A pre-operative diagnosis was achieved in 69 per cent of cases. Intrathoraic neoplasia had the lowest pre-operative diagnosis rate (5.5 per cent). Mortality rates of 21 per cent were recorded and were significantly higher for intrathoracic neoplasia (50 per cent) and significantly lower for persistent ductus arteriosus (7.4 per cent) and vascular ring anomaly (0 per cent). Median sternotomy was the preferred approach for pyothorax (85 per cent) and penetrating thoracic injuries (66 per cent). Intercostal thoracotomy was the preferred approach for all other diseases. Postoperative complications occurred in 39 per cent of cases. Wound complications were more common for pyothorax (45 per cent) and following median sternotomy (71 per cent). Thoracic drains were placed in 77 per cent of cases and complications were recorded in 23 per cent. Pyothorax and chylothorax had thoracic drains maintained for significantly longer periods of time. Longer thoracic drain duration was correlated significantly with increased complication rates.

CLINICAL SIGNIFICANCE

The short-term outcome following thoracic surgery is influenced by diagnosis. The thoracic approach is determined by intrathoracic disease, but may influence outcome by affecting the incidence of postoperative wound complications. The risk of thoracic drain complications increases with drain duration, which is influenced by the underlying disease. Drains should be maintained for the minimal amount of time possible.

摘要

目的

评估影响犬类胸外科手术短期(<14天)预后的因素。

方法

对五年内接受开胸手术的98只犬进行回顾性研究。

结果

69%的病例获得了术前诊断。胸腔内肿瘤的术前诊断率最低(5.5%)。记录的死亡率为21%,胸腔内肿瘤的死亡率显著更高(50%),动脉导管未闭(7.4%)和血管环异常(0%)的死亡率显著更低。正中胸骨切开术是脓胸(85%)和穿透性胸部损伤(66%)的首选手术入路。肋间开胸术是所有其他疾病的首选手术入路。39%的病例发生了术后并发症。脓胸(45%)和正中胸骨切开术后(71%)伤口并发症更为常见。77%的病例放置了胸腔引流管,23%记录有并发症。脓胸和乳糜胸的胸腔引流管留置时间明显更长。胸腔引流管留置时间越长,并发症发生率越高。

临床意义

胸外科手术后的短期预后受诊断影响。手术入路由胸腔内疾病决定,但可能通过影响术后伤口并发症的发生率来影响预后。胸腔引流管并发症的风险随引流时间增加,而引流时间受基础疾病影响。引流管应尽可能短时间留置。

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