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胸腔镜肺叶切除术的胸壁提升术:两只猫的技术与结果

Chest wall lift for thoracoscopic lung lobectomy: Technique and results in two cats.

作者信息

Aertsens Adrien, Tsoi Helen, Esala Micah, Wheeler Emily P

机构信息

College of Veterinary Medicine, Hixson- Lied Small Animal Hospital, Iowa State University, Ames, Iowa, USA.

Animal Health Clinic, Fargo, North Dakota, USA.

出版信息

Vet Surg. 2025 May;54(4):694-704. doi: 10.1111/vsu.14204. Epub 2025 Jan 10.

Abstract

OBJECTIVE

To report the technique and outcomes of utilizing chest wall lift to perform thoracoscopic surgery in two cats.

STUDY DESIGN

Short case series.

ANIMALS

Client-owned cats (n = 2).

METHODS

A geriatric cat was referred for pleural effusion secondary to a left cranial lung lobe mass. A thoracoscopic exploration of the left hemithorax was planned with a lift device used for laparoscopy and attached to a ceiling mount. A young cat was referred for a foreign body lodged in the right caudal bronchus. Attempted bronchoscopic retrieval was unsuccessful. Thoracoscopic lung lobectomy was planned using a bent Steinmann pin as a lift device placed at the eighth intercostal space, along one of the cannula.

RESULTS

Thoracic lift was achieved with the patient in right lateral recumbency for the first cat, leading to immediate improvement in the oxygenation and ventilation status of the patient while simultaneously allowing for continued thoracoscopic exploration of the hemithorax. With two additional ports, thoracoscopic dissection of the adhesions was performed prior to thoracoscopic assisted lung lobectomy at the fourth intercostal space. For the second cat, thoracic lift was performed with the patient in left lateral recumbency and allowed successful 3-port thoracoscopic lung lobectomy. No complication related to the use of either lift device was noted.

CONCLUSION

Chest wall lift improved anesthesia respiratory status in one cat and increased the working space to perform thoracoscopic procedures in both cats.

CLINICAL SIGNIFICANCE

This novel and simple technique could increase working space without anesthesia impairment, allowing thoracoscopic procedures in selected feline patients.

摘要

目的

报告在两只猫中利用胸壁提升技术进行胸腔镜手术的方法及结果。

研究设计

短病例系列。

动物

客户拥有的猫(n = 2)。

方法

一只老年猫因左颅肺叶肿块继发胸腔积液前来就诊。计划使用用于腹腔镜检查的提升装置并将其连接到天花板支架上,对左半胸进行胸腔镜探查。一只年轻猫因右尾支气管内有异物前来就诊。尝试通过支气管镜取出未成功。计划使用一根弯曲的斯氏针作为提升装置,置于第八肋间,沿着其中一个套管进行胸腔镜肺叶切除术。

结果

第一只猫右侧卧位时实现了胸壁提升,使患者的氧合和通气状态立即得到改善,同时允许继续对半胸进行胸腔镜探查。通过另外两个端口,在第四肋间进行胸腔镜辅助肺叶切除术之前,先进行胸腔镜下粘连松解术。对于第二只猫,左侧卧位时进行了胸壁提升,并成功进行了三端口胸腔镜肺叶切除术。未发现与使用任何一种提升装置相关的并发症。

结论

胸壁提升改善了一只猫的麻醉呼吸状态,并增加了两只猫进行胸腔镜手术的工作空间。

临床意义

这种新颖且简单的技术可以在不损害麻醉的情况下增加工作空间,从而允许在选定的猫科动物患者中进行胸腔镜手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/434b/12063712/1120ed9ac5ed/VSU-54-694-g004.jpg

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