Vachon A M, Fischer A T
Chino Valley Equine Hospital, California 91710, USA.
Equine Vet J. 1998 Nov;30(6):467-75. doi: 10.1111/j.2042-3306.1998.tb04521.x.
Thirty-two thoracoscopies were performed in 28 horses. Sixteen horses were affected with pleuropneumonia whereas 12 were affected with various other thoracic conditions. The indications for thoracoscopy was diagnostic in 19 cases, therapeutic in 11 cases and both diagnostic and therapeutic in 2 cases. Twenty-six thoracoscopies were done standing whereas 6 were performed under general anaesthesia. The specific procedures performed during thoracoscopy were exploratory only (7), biopsy of the lung and lymph nodes (10), drain placement into pleural effusions (2) and abscesses (5), exploration prior to thoracotomy (2), transection of pleural adhesions and decortication (1) and window pericardectomy (2). Diaphragmatic hernia repair (2) and partial pneumonectomy (1) were initiated thoracoscopically but conversion to thoracotomy was necessary for completion. Standing thoracoscopy was well tolerated in most horses. Transient exacerbation of pulmonary compromise evidenced by tachypnoea was readily alleviated by reinflation of the lung. Standing thoracoscopy provided good visualisation of the dorsal and lateral structures of the thorax. The ventral thoracic structures and the cranial ventral diaphragmatic surfaces of the lungs were best visualised in dorsal or lateral recumbency under general anaesthesia. Thoracoscopy is a safe and useful diagnostic and therapeutic tool in horses with thoracic diseases.
对28匹马进行了32次胸腔镜检查。16匹马患有胸膜肺炎,而12匹马患有其他各种胸部疾病。胸腔镜检查的指征在19例中为诊断性,11例为治疗性,2例为诊断兼治疗性。26次胸腔镜检查是在站立状态下进行的,6次是在全身麻醉下进行的。胸腔镜检查期间进行的具体操作仅为探查(7例)、肺和淋巴结活检(10例)、胸腔积液引流(2例)和脓肿引流(5例)、开胸术前探查(2例)、胸膜粘连切断和剥脱术(1例)以及心包开窗术(2例)。膈肌疝修补术(2例)和部分肺切除术(1例)在胸腔镜下开始,但需要转为开胸术才能完成。大多数马匹对站立式胸腔镜检查耐受性良好。因呼吸急促而出现的肺部功能暂时恶化,通过肺再充气很容易得到缓解。站立式胸腔镜检查能很好地观察胸部的背侧和外侧结构。在全身麻醉下的背卧位或侧卧位能最好地观察胸部腹侧结构和肺的头侧腹侧膈肌表面。胸腔镜检查是马匹胸部疾病安全且有用的诊断和治疗工具。