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胸腔镜心包开窗术治疗15只犬的心包积液

Thoracoscopic pericardial window for management of pericardial effusion in 15 dogs.

作者信息

Atencia S, Doyle R S, Whitley N T

机构信息

Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Herts, SG5 3HR.

出版信息

J Small Anim Pract. 2013 Nov;54(11):564-9. doi: 10.1111/jsap.12138. Epub 2013 Oct 3.

Abstract

OBJECTIVES

To report short-term complications and long-term outcomes of thoracoscopic pericardial window for management of pericardial effusion in dogs.

METHODS

Retrospective study of dogs in which thoracoscopic pericardial window was performed using a three-cannula technique. Surgery time, complications, postoperative management, area of resected pericardium, histopathology results and outcome were evaluated.

RESULTS

Diagnoses included dogs with idiopathic pericardial effusion (n = 10), cardiac mass (n = 4) and mesothelioma (n = 1). One case required conversion to sternotomy. Median thoracoscopic surgery time was 52 · 5 (range, 45-80) minutes. Complications occurred in four (26%) cases. Median time to discharge was one (range, 1-6) day. Of dogs with idiopathic pericardial effusion, one is alive at 150 days, one was lost to follow-up at 180 days while eight were euthanased of which five were for unrelated reasons. All dogs with neoplastic causes died or were euthanased because of their illness. Median survival time for dogs with idiopathic pericardial effusion (635 days; range, 70-1165) was significantly longer than that for dogs with neoplasia (30 days; range, 1-107).

CLINICAL SIGNIFICANCE

Thoracoscopic pericardial window is of low morbidity with short surgery and hospitalisation times. It provides good long-term control of idiopathic pericardial effusion but short-term palliation of clinical signs in dogs with neoplastic disease.

摘要

目的

报告胸腔镜心包开窗术治疗犬心包积液的短期并发症和长期预后。

方法

对采用三套管技术进行胸腔镜心包开窗术的犬进行回顾性研究。评估手术时间、并发症、术后管理、切除心包面积、组织病理学结果和预后。

结果

诊断包括特发性心包积液犬(n = 10)、心脏肿物犬(n = 4)和间皮瘤犬(n = 1)。1例需要转为胸骨切开术。胸腔镜手术中位时间为52.5(范围45 - 80)分钟。4例(26%)出现并发症。中位出院时间为1(范围1 - 6)天。特发性心包积液犬中,1例存活150天,1例在180天时失访,8例实施安乐死,其中5例因无关原因。所有肿瘤性病因犬均因疾病死亡或实施安乐死。特发性心包积液犬的中位生存时间(635天;范围70 - 1165天)显著长于肿瘤性疾病犬(30天;范围1 - 107天)。

临床意义

胸腔镜心包开窗术发病率低,手术和住院时间短。它能很好地长期控制特发性心包积液,但对肿瘤性疾病犬仅能短期缓解临床症状。

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