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原发性自发性气胸犬的手术治疗及预后:110 例病例报告(2009-2019 年)。

Surgical management and outcome of dogs with primary spontaneous pneumothorax: 110 cases (2009-2019).

出版信息

J Am Vet Med Assoc. 2021 Jun 1;258(11):1229-1235. doi: 10.2460/javma.258.11.1229.

Abstract

OBJECTIVE

To describe surgical management and associated outcomes for dogs with primary spontaneous pneumothorax.

ANIMALS

110 client-owned dogs with primary spontaneous pneumothorax that underwent surgical management.

PROCEDURES

Medical records at 7 veterinary teaching hospitals were reviewed. Data collected included signalment, history, clinical signs, radiographic and CT findings, surgical methods, intraoperative and postoperative complications, outcomes, and histopathologic findings. Follow-up information was obtained by contacting the referring veterinarian or owner.

RESULTS

110 dogs were included, with a median follow-up time of 508 days (range, 3 to 2,377 days). Ninety-nine (90%) dogs underwent median sternotomy, 9 (8%) underwent intercostal thoracotomy, and 2 (2%) underwent thoracoscopy as the sole intervention. Bullous lesions were most commonly found in the left cranial lung lobe (51/156 [33%] lesions) and right cranial lung lobe (37/156 [24%] lesions). Of the 100 dogs followed up for > 30 days, 13 (13%) had a recurrence of pneumothorax, with median time between surgery and recurrence of 9 days. Recurrence was significantly more likely to occur ≤ 30 days after surgery, compared with > 30 days after surgery. Recurrence > 30 days after surgery was rare (3 [3%]). No risk factors for recurrence were identified.

CONCLUSIONS AND CLINICAL RELEVANCE

Lung lobectomy via median sternotomy resulted in resolution of pneumothorax in most dogs with primary spontaneous pneumothorax. Recurrence of pneumothorax was most common in the immediate postoperative period, which may have reflected failure to identify lesions during the initial thoracic exploration, rather than development of additional bullae.

摘要

目的

描述原发性自发性气胸犬的手术治疗方法及相关转归。

动物

110 只接受过手术治疗的原发性自发性气胸的患犬。

方法

对 7 所兽医教学医院的病历进行了回顾。收集的数据包括一般信息、病史、临床症状、放射影像学和 CT 检查结果、手术方法、术中及术后并发症、转归和组织病理学发现。通过联系转诊兽医或主人获取随访信息。

结果

共纳入 110 只犬,中位随访时间为 508 天(范围,3~2377 天)。99 只(90%)犬接受了正中开胸术,9 只(8%)犬接受了肋间开胸术,2 只(2%)犬仅接受了胸腔镜检查。最常发现疱性病变位于左颅侧肺叶(51/156[33%]病变)和右颅侧肺叶(37/156[24%]病变)。在 100 只随访时间>30 天的犬中,有 13 只(13%)发生气胸复发,手术与复发之间的中位时间为 9 天。与>30 天相比,手术后≤30 天内复发的可能性显著更高。>30 天复发的情况罕见(3[3%])。未确定复发的风险因素。

结论和临床相关性

通过正中开胸术进行肺叶切除术可使大多数原发性自发性气胸患犬的气胸得到缓解。气胸复发最常见于术后即刻,这可能反映了在初次胸部探查中未能识别病变,而不是新出现疱性病变。

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