Scott Jacqueline, Singh Ameet, Monnet Eric, Coleman Kristin A, Runge Jeffrey J, Case Joseph Brad, Mayhew Philipp D
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
Department of Clinical Studies, Colorado State University, Fort Collins, Colorado.
Vet Surg. 2017 Jul;46(5):722-730. doi: 10.1111/vsu.12661. Epub 2017 Apr 29.
To report the perioperative findings and outcome of dogs undergoing video-assisted thoracic surgery (VATS) for the management of pyothorax.
Multi-institutional, retrospective study.
Client-owned dogs (n = 14).
Medical records of dogs with pyothorax managed via VATS were reviewed for signalment, history, clinical signs, clinicopathological findings, diagnostic imaging results, surgical variables, bacterial culture and sensitivity results, post-operative management and outcome. VATS was performed after placing a paraxyphoid endoscopic portal and 2-3 intercostal instrument portals. VATS exploration was followed by one or more of the following: mediastinal debridement, tissue sampling, pleural lavage, and placement of a thoracostomy tube.
Two dogs (14%) required conversion from VATS to an open thoracotomy to completely resect proliferative mediastinal tissue. These dogs had severe pleural effusion on preoperative thoracic radiographs and one had severely thickened contrast-enhancing mediastinum on preoperative computed tomography (CT). The cause of pyothorax was identified as a penetrating gastric foreign body (n = 2), migrating plant material (n = 2), and idiopathic (n = 10). The median follow-up time was 143 days (range, 14-2402 days). All dogs were discharged from the hospital and their clinical signs resolved. One patient had recurrence of a pyothorax requiring revision surgery 17 months postoperatively.
VATS allows minimally invasive treatment of uncomplicated canine pyothorax. Preoperative thoracic CT may help identify candidates for VATS among dogs with pyothorax.
报告接受电视辅助胸腔镜手术（VATS）治疗脓胸的犬的围手术期发现及结果。
多机构回顾性研究。
客户拥有的犬（n = 14）。
回顾通过VATS治疗脓胸的犬的病历，包括特征、病史、临床症状、临床病理检查结果、诊断性影像学结果、手术变量、细菌培养及药敏结果、术后管理及结果。在剑突旁放置内镜入口及2 - 3个肋间器械入口后进行VATS。VATS探查后进行以下一项或多项操作：纵隔清创、组织采样、胸腔灌洗及放置胸腔造瘘管。
2只犬（14%）需要从VATS转为开胸手术以完全切除增生性纵隔组织。这些犬术前胸部X线片显示有严重胸腔积液，其中1只犬术前计算机断层扫描（CT）显示纵隔明显增厚且有强化。脓胸的病因被确定为穿透性胃内异物（n = 2）、移行的植物性物质（n = 2）及特发性（n = 10）。中位随访时间为143天（范围，14 - 2402天）。所有犬均出院，临床症状消失。1例患者术后17个月脓胸复发，需要再次手术。
VATS可对单纯性犬脓胸进行微创治疗。术前胸部CT有助于在脓胸犬中识别适合VATS的病例。
