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正中胸骨切开术与肋间胸廓切开术用于肺叶切除术:134只犬短期结果的比较

Median sternotomy versus intercostal thoracotomy for lung lobectomy: A comparison of short-term outcome in 134 dogs.

作者信息

Bleakley Seth, Phipps Kevin, Petrovsky Brian, Monnet Eric

机构信息

VCA Sacramento Veterinary Referral Center, Sacramento, California.

Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado.

出版信息

Vet Surg. 2018 Jan;47(1):104-113. doi: 10.1111/vsu.12741. Epub 2017 Nov 10.

Abstract

OBJECTIVE

To compare short-term outcomes between dogs undergoing lung lobectomy via median sternotomy (MS) or intercostal thoracotomy (ICT).

STUDY DESIGN

Retrospective case control study.

METHODS

Medical records of dogs that underwent lung lobectomy via MS or ICT at a single institution were reviewed for demographics, intraoperative findings, and postoperative management and outcomes. Dogs with pleural effusion, pneumonia, migrating foreign body, lung abscess, spontaneous pneumothorax, or lung lobe torsion were excluded. Short-term outcome factors up were compared up to the time of death, euthanasia, or discharge from the hospital.

RESULTS

One hundred and thirty-four dogs met the inclusion criteria. Forty-one (31%) dogs underwent MS and 93 dogs (69%) underwent ICT. Fluid production from the chest tube (P = .0061), alveolar arterial pressure gradient (P = .0001), and complications requiring intervention (P = .0245) were more common in the MS group than the ICT group. Pain management and all other short-term outcome factors did not differ between procedures. Five dogs from the MS group and 4 from the ICT group were euthanized in the postoperative period (P = .0925).

CONCLUSION

In a surgical procedure that does not preclude either approach, ICT may be more desirable than MS in terms of postoperative pain, oxygenation, and complications. However, since no other short-term measure of outcome differed, we can state that both MS and ICT are well tolerated by dogs.

摘要

目的

比较经正中胸骨切开术(MS)或肋间胸廓切开术(ICT)进行肺叶切除术的犬的短期预后。

研究设计

回顾性病例对照研究。

方法

回顾了在单一机构接受MS或ICT肺叶切除术的犬的病历,以了解其人口统计学、术中发现、术后管理及预后情况。排除有胸腔积液、肺炎、游走性异物、肺脓肿、自发性气胸或肺叶扭转的犬。比较直至死亡、安乐死或出院时的短期预后因素。

结果

134只犬符合纳入标准。41只(31%)犬接受了MS,93只(69%)犬接受了ICT。MS组胸腔引流管引流量(P = .0061)、肺泡动脉压梯度(P = .0001)及需要干预的并发症(P = .0245)比ICT组更常见。两种手术的疼痛管理及所有其他短期预后因素无差异。MS组有5只犬、ICT组有4只犬在术后被安乐死(P = .0925)。

结论

在不排除任何一种手术方式的情况下,就术后疼痛、氧合及并发症而言,ICT可能比MS更可取。然而,由于其他短期预后指标无差异,我们可以认为犬对MS和ICT的耐受性均良好。

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