{"title":"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","authors":"Erin A. Gibson, Kelsey Brust, Michele A. Steffey","doi":"10.1111/vsu.14095","DOIUrl":null,"url":null,"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 (<jats:italic>n</jats:italic> = 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 CO<jats:sub>2</jats:sub> 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.","PeriodicalId":23667,"journal":{"name":"Veterinary Surgery","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluation of mediastinoscopy for cranial mediastinal and tracheobronchial lymphadenectomy in canine cadavers\",\"authors\":\"Erin A. Gibson, Kelsey Brust, Michele A. Steffey\",\"doi\":\"10.1111/vsu.14095\",\"DOIUrl\":null,\"url\":null,\"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 (<jats:italic>n</jats:italic> = 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 CO<jats:sub>2</jats:sub> 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.\",\"PeriodicalId\":23667,\"journal\":{\"name\":\"Veterinary Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-04-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Veterinary Surgery\",\"FirstCategoryId\":\"97\",\"ListUrlMain\":\"https://doi.org/10.1111/vsu.14095\",\"RegionNum\":2,\"RegionCategory\":\"农林科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"VETERINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Veterinary Surgery","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.1111/vsu.14095","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
Evaluation of mediastinoscopy for cranial mediastinal and tracheobronchial lymphadenectomy in canine cadavers
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.
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.