Pulmonary Surgery

Question 1

Marvel and Monnet, Vet Surg, 2013:
Lung biopsy techniques

Outcome of lung biopsy using a vessel sealant device?

Answer 1

Marvel and Monnet, Vet Surg, 2013:

Biopsies performed with a vessel sealant device did not consistently seal every biopsy and leaked at pressures <20cm H2O

Question 2

Imhoff and Monnet, Vet Surg, 2016:
Lung biopsies using the Tri-Staple graduated compression staples

1. Leakage pressures using the Tri-Staple medium/thick vs Tri-Staple vascular/medium vs Endo GIA stapler?
2. Location of leakage for all types of stapling?

Answer 2

Imhoff and Monnet, Vet Surg, 2016:

1. The Tri-Staple medium/thick and Tri-Staple vascular/medium staplers leaked at lower airway pressures than the Endo GIA stapler and may not be suitable for canine lung biopsy
2. For all types of stapling, leakage occurred at the beginning and end of the staple lines rather than along the line of staples

Question 3

Wavreille, Vet Surg, 2016:
Pneumonectomy

1. Overall complication rate?
2. Mortality rate within 2 weeks post-op for dogs vs cats?
3. Association between right pneumonectomy and morbidity or mortality rates?

Answer 3

Wavreille, Vet Surg, 2016:

1. Overall complication rate: 78%
2. Mortality rate: 6% for dogs vs 20% for cats
3. No association between right pneumonectomy and morbidity or mortality

Question 4

Majeski, Vet Surg, 2016:
Pneumonectomy

1. Mortality rate for dogs vs cats?
2. Post-op PaO2 and A-a gradient in dogs that underwent pneumonectomy vs single lung lobectomy?
3. Any survival benefit of left vs right pneumonectomy?

Answer 4

Majeski, Vet Surg, 2016:

1. Mortality rate: 6% for dogs vs 14% for cats
2. Dogs that underwent pneumonectomy had higher post-op PaO2 and lower A-a gradient compared to dogs that underwent single lung lobectomy - dogs undergoing pneumonectomy may have already begun to institute compensatory mechanisms for reduced pulmonary function, explaining the superior function of existing pulmonary parenchyma; in addition, the contralateral lung lobes may be able to expand to a greater degree after pneumonectomy compared to single lobectomy
3. No survival benefit of left vs right pneumonectomy

Question 5

Latimer, JAVMA, 2017:
Lung lobe torsion

1. 86% of the dogs also had what hematological finding?
2. Most commonly affected lung lobe?

Answer 5

Latimer, JAVMA, 2017:

1. 86% also had anemia
2. Most commonly affect lung lobe was the left cranial lung lobe (57%), followed by the right middle (29%) then the right cranial (14%)

Question 6

Park, Vet Surg, 2018:
Lung lobe torsion

1. Mortality rate?
2. What % of cases had torsion of the right middle or left cranial lung lobes?
3. In Pugs, which lung lobe was most commonly affected?
4. Survival rate was lower for torsion of which lung lobe(s)?
5. In 25% of the cases, what was identified as a predisposing cause of lung lobe torsion?

Answer 6

Park, Vet Surg, 2018:

1. Mortality rate: 8%
2. 84% had torsion of the right middle or left cranial lung lobes
3. In Pugs, the left cranial lung lobe was most commonly affected (91%)
4. Dogs with concurrent torsion of the right cranial and right middle lung lobes were less likely to survive than those with torsion of the left cranial lung lobe
5. In 25% of the cases, pleural effusion was identified as a predisposing cause of lung lobe torsion, most of which were chylothorax

Question 7

Bleakley, Vet Surg, 2018:

Short-term outcome following median sternotomy vs intercostal thoracotomy for lung lobectomy?

Answer 7

Bleakley, Vet Surg, 2018:

The median sternotomy group had increased fluid production from the chest tube, a greater A-a pressure gradient (hypoxemia), more complications requiring intervention, and a prolonged hospital stay

Question 8

Cronin, Vet Surg, 2019:
Lung lobectomy

1. What % leaked?
2. Incidence of bronchial stump failures for lobectomies performed with a pre-tied ligature loop vs stapler vs suture ligation?

Answer 8

Cronin, Vet Surg, 2019:

1. 0% leaked
2. Incidence of bronchial stump failures for lobectomies performed with a pre-tied ligature loop vs stapler vs suture ligation did not differ

Question 9

Nylund, Vet Surg, 2019:
Thoracoscopic-assisted lung lobectomy

1. Outcome of lung lobectomies performed with a TA stapler?
2. Outcome of lung lobectomies performed with a resorbable self-locking ligation device (LigaTie)?

Answer 9

Nylund, Vet Surg, 2019:

1. 40% of the TA stapled sites leaked at a mean pressure of 22cm H2O when the staple line was >5mm from the hilus, but no leaks occurred when the staple line was up to 5mm from the hilus
2. All LigaTie sites did not leak at maximum airway pressures

Question 10

Bruckner, JSAP, 2019:
12mm Caiman vessel-sealing device for peripheral lung biopsy and lung lobectomy

1. What % of the samples leaked below a pressure of 25cm H2O?
2. Extent of collateral damage in specimens?
3. Quality of biopsy specimens?

Answer 10

Bruckner, JSAP, 2019:

1. 0% leaked below 25cm H2O
2. 2.7mm collateral damage in all specimens
3. All biopsy specimens were of good diagnostic quality