Evaluation of mediastinoscopy for cranial mediastinal and tracheobronchial lymphadenectomy in canine cadavers

IF 1.3 2区 农林科学 Q2 VETERINARY SCIENCES Veterinary Surgery Pub Date : 2024-04-30 DOI:10.1111/vsu.14095
Erin A. Gibson, Kelsey Brust, Michele A. Steffey
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Abstract

ObjectiveTo report technical feasibility and describe procedural details of a novel single incision minimally invasive approach to the mediastinum in cadaver dogs.Study designCadaveric study.AnimalsLarge breed (25–40 kg) cadaver dogs (n = 10).MethodsThree of 10 cadavers were used for preliminary technique development without data recording. Cadaver specimens underwent pre‐ and postoperative thoracic computed tomographic scans. Seven dogs were placed in dorsal recumbency and mediastinoscopy was performed via a SILS port placed cranial to the thoracic inlet with CO2 insufflation of the mediastinum at 2–4 mmHg. Retrieval of all CT and visually identified mediastinal lymph nodes (LN) was attempted; endoscopic compartmental and individual LN dissection times and subjective operative challenges were recorded. Procedural success scores for visualization and dissection as well as NASA‐task force index scores were recorded per lymph node, per cadaver.ResultsMedian time required for initial approach including SILS placement was 5 min (range 5–10 min). Individual LN retrieval times ranged from 2 to 32 min. Mediastinoscopic retrieval of LNs was most commonly successful for the left tracheobronchial LN (7/7), followed by the right tracheobronchial LN (4/7), the left and right sternal LNs (3/7 each), and the cranial mediastinal LNs (1/7). Post‐procedure pleural gas was identified on CT in 4/7 cadavers.ConclusionsMediastinoscopy as reported was feasible in large breed canine cadavers and retrieval or cup biopsy of a variety of lymph nodes is possible from the described approach. Application in living animals and its associated challenges should be further investigated.Clinical significanceMediastinoscopy may provide a novel minimally invasive approach to the evaluation and oncologic staging of the cranial mediastinum in dogs.
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评估纵隔镜在犬尸体上进行头颅纵隔和气管支气管淋巴结切除术的效果
研究设计尸体研究。动物大型犬(25-40 千克)尸体(n = 10)。方法 10 具尸体中有 3 具用于初步技术开发,未记录数据。尸体标本接受术前和术后胸部计算机断层扫描。将七只狗置于背卧位,通过置于胸腔入口头侧的 SILS 端口进行纵隔镜检查,并以 2-4 mmHg 的二氧化碳对纵隔进行充气。尝试检索所有 CT 和肉眼识别的纵隔淋巴结 (LN);记录内窥镜分区和单个 LN 清扫时间以及主观手术挑战。结果包括 SILS 置入在内的初始方法所需时间中位数为 5 分钟(5-10 分钟不等)。单个淋巴结的取材时间从 2 分钟到 32 分钟不等。纵隔镜取材最成功的是左侧气管支气管LN(7/7),其次是右侧气管支气管LN(4/7)、左侧和右侧胸骨LN(各3/7)以及颅纵隔LN(1/7)。结论所报道的纵隔内窥镜检查在大型犬尸体中是可行的,而且可以通过所述方法对各种淋巴结进行检索或杯状活检。在活体动物中的应用及其相关挑战应进一步研究。临床意义纵隔镜检查可为狗的头颅纵隔评估和肿瘤分期提供一种新的微创方法。
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来源期刊
Veterinary Surgery
Veterinary Surgery 农林科学-兽医学
CiteScore
3.40
自引率
22.20%
发文量
162
审稿时长
8-16 weeks
期刊介绍: Veterinary Surgery, the official publication of the American College of Veterinary Surgeons and European College of Veterinary Surgeons, is a source of up-to-date coverage of surgical and anesthetic management of animals, addressing significant problems in veterinary surgery with relevant case histories and observations. It contains original, peer-reviewed articles that cover developments in veterinary surgery, and presents the most current review of the field, with timely articles on surgical techniques, diagnostic aims, care of infections, and advances in knowledge of metabolism as it affects the surgical patient. The journal places new developments in perspective, encompassing new concepts and peer commentary to help better understand and evaluate the surgical patient.
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