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胸腔镜辅助肺叶切除术治疗犬的并发症及结果。

Complications and outcomes of thoracoscopic-assisted lung lobectomy in dogs.

机构信息

Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Champaign, Illinois, USA.

Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.

出版信息

Vet Surg. 2023 Jan;52(1):106-115. doi: 10.1111/vsu.13886. Epub 2022 Sep 27.

Abstract

OBJECTIVE

To describe complications and outcomes of dogs undergoing thoracoscopic-assisted (TA) lung lobectomy.

STUDY DESIGN

Multi-institutional, retrospective study.

ANIMALS

Client-owned dogs (n = 30).

METHODS

Medical records of dogs that underwent TA lung lobectomy were reviewed. Signalment, bodyweight, clinical signs, imaging findings, surgical variables, complications, and short-term/long-term outcome were assessed. Thoracoscopic-assisted lung lobectomy was performed with a mini-thoracotomy.

RESULTS

Twelve intraoperative complications were recorded in 11 dogs, 6 requiring conversion to open thoracotomy. Reasons for conversion were reported in 5/6 dogs and included adhesions (2), difficultly manipulating the lesion through the mini-thoracotomy (2), and acute oxygen desaturation (1). One lung ventilation was successful in 4 of the 7 dogs in which this was attempted. A linear stapling device (DST series Medtronic, Minneapolis, Minnesota) was used for lung lobe ligation in 14 dogs. Twenty-three dogs underwent surgery for a neoplastic lesion, with 19 of these being carcinoma. The median lesion size was 4.3 cm (range 1-10 cm); margins were clean, except in 1 dog. Complications were documented in 8 dogs prior to discharge, 5 of these being classified as mild. Twenty-nine dogs were discharged at a median of 47 h postoperatively (range 24-120 h). Death was reported in 9 dogs, with a median survival time of 168 days (range 70-868 days).

CONCLUSION

Thoracoscopic-assisted lung lobectomy was achieved with few major complications in the population reported here. Dogs were able to be discharged from hospital quickly, with most surviving beyond the follow-up period.

CLINICAL SIGNIFICANCE

Thoracoscopic-assisted lung lobectomy may be considered to facilitate the excision of larger pulmonary lesions or to treat smaller dogs, in which a thoracoscopic excision may be technically more challenging.

摘要

目的

描述接受胸腔镜辅助(TA)肺叶切除术的犬只的并发症和结果。

研究设计

多机构、回顾性研究。

动物

患犬(n=30)。

方法

回顾性分析接受 TA 肺叶切除术的犬只的病历。评估了品种、体重、临床症状、影像学发现、手术变量、并发症以及短期/长期结果。TA 肺叶切除术是通过小开胸术进行的。

结果

记录了 11 只狗的 12 个术中并发症,其中 6 只需要转为开胸术。5/6 只狗报告了转为开胸术的原因,包括粘连(2 只)、难以通过小开胸术操作病变(2 只)和急性氧饱和度降低(1 只)。在尝试进行单侧肺通气的 7 只狗中,有 4 只成功。14 只狗使用线性吻合器(DST 系列 Medtronic,明尼苏达州明尼阿波利斯市)结扎肺叶。23 只狗因肿瘤病变接受手术治疗,其中 19 只为癌。病变大小中位数为 4.3cm(范围 1-10cm);除 1 只狗外,其余均为切缘干净。在出院前,8 只狗出现了并发症,其中 5 只被归类为轻度。29 只狗在术后中位数 47h(范围 24-120h)出院。报告了 9 只狗死亡,中位生存时间为 168 天(范围 70-868 天)。

结论

在报告的人群中,TA 肺叶切除术很少发生重大并发症。狗很快就能出院,大多数狗在随访期后仍能存活。

临床意义

TA 肺叶切除术可用于切除较大的肺部病变,或治疗技术上更具挑战性的较小的狗。

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