[논문]비글견에서 편측성 분리폐 환기를 이용한 흉강경 우중폐엽 절제술을 위한 포트 위치

박지영; 이해범; 정성목

doi:10.17555/ksvc.2015.02.32.1.9

비글견에서 편측성 분리폐 환기를 이용한 흉강경 우중폐엽 절제술을 위한 포트 위치
Portal Placement for Thoracoscopic Right Middle Lung Lobectomy with One-Lung Ventilation in Beagle Dogs 원문보기

Journal of veterinary clinics = 한국임상수의학회지, v.32 no.1, 2015년, pp.9 - 15

박지영 (충남대학교 수의과대학.동물의과학연구소) , 이해범 (충남대학교 수의과대학.동물의과학연구소) , 정성목 (충남대학교 수의과대학.동물의과학연구소)

초록
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본 연구는 10 kg 미만의 소형견에서 흉강경을 이용한 우측 중폐엽 절제술을 적용할 때, 적합한 포트 접근법의 설정을 위하여 실시되었다. 평균 체중 $8.67{\pm}0.49kg$의 비글견 10마리에서 전신 마취를 실시한 후 기관 내시경 유도하에 우측 주기관지를 폐쇄하여 편측성 분리폐 환기를 실시하였다. 포트는8-6-10 늑간과 8-6-5 늑간을 통한 두 가지 접근법으로 위치시켰고, 흉강경 우중폐엽 절제술에는 복강경용 자가 절단 스테플러와 검체 회수 주머니가 사용되었다. 각 접근법은 1) 시각화, 2) triangulation; 흉강내 기구간 충돌, 3) 스테플러의 폐문부 접근 및 적용의 용이성, 4) 검체 회수 주머니 사용의 장해 여부, 5) 술자의 편의도의 5가지 항목을 점수화하여 평가하였다. 모든 개체에서 편측성 분리 폐 환기에 의해 양호한 작업 공간이 확보되었고, 성공적인 흉강경 우중폐엽 절제술이 완료되었다. 어느 경우에서도 포트 위치를 수정할 필요는 없었으며, 의인성 합병증 역시 발생하지 않았다. 두가지 접근법 모두 높은 점수를 얻어, 이들은 10 kg미만의 개에서 편측성 분리폐 환기하에 자가 절단 스테플러를 이용한 흉강경 우중폐엽 절제술을 실시함에 적합한 것으로 확인되었다.

Abstract ▼ AI-Helper

Purpose of this study is to determine the reasonable portal approach for thoracoscopic right middle lung lobectomy in small sized dogs under 10 kg. Ten healthy beagle dogs weighing $8.67{\pm}0.49kg$ were included. Under general anesthesia, one-lung ventilation (1LV) was achieved using endobronchial blocker with guidance of fiber-optic bronchoscope. Two portal approaches were used; 8-6-10 intercostal space (ICS) and 8-6-5 ICS approach. Thoracoscopic right middle lung lobectomy was performed using endoscopic linear self-cutting stapler and specimen retrieval bag. Each approach was evaluated by scoring 0; bad, 1; endurable, 2; good, 3; excellent in following five category, 1) visualization, 2) triangulation; instrumental sword fighting in the thoracic cavity, 3) approach to hilar pedicle; application of stapler, 4) any obstacles in applicating Lap Bag, and 5) the operator's convenience. Favorable working space was secured by 1LV and thoracoscopic right middle lung lobectomy was successfully completed in all dogs. There was no need to change the portal location and iatrogenic complication. Most of scores were good to excellent in both approaches. Consequently, both approaches are feasible methods for thoracoscopic right middle lung lobectomy with one lung ventilation using endoscopic linear self-cutting stapler in dogs weighing less than 10 kg.

주제어

AI 본문요약
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문제 정의

With all these aspects, purpose of this study was to determine the reasonable portal approach for thoracoscopic right middle lung lobectomy in small sized dogs. We investigated the portal sites for thoracoscopic right middle lung lobectomy with 1LV in Beagle dogs weighing less than 10 kg and these feasibility separated in two portal approaches.

제안 방법

Resected lung lobe was retrieved using specimen retrieval pouch through the 12 mm portal site without retraction of the rib. Surgical field was re-explored for the inspection of hemorrhage, air leakage, or tearing of pedicle.
This study was conducted in healthy dogs, however, in case of too large pulmonary mass or mass that are too close to hilus would impair the visualization and make manipulation for dissection and stapler placement difficult even though reasonable portal placement. In these conditions, there would be no choice without conversion to standard open thoracotomy.

대상 데이터

Ten 3 year old, purpose-bred intact male Beagle dogs weighing 8.67 ± 0.49 kg (range: 7.7~9.6 kg, BCS: 4/9~6/9) were included.

참고문헌 (29)

Bauquier SH, Culp WT, Lin RC, Larenza MP. One-lung ventilation using a wire-guided endobronchial blocker for thoracoscopic pericardial fenestration in a dog. Can Vet J 2010; 51: 1135-1138.

상세보기
Borenstein N, Behr L, Chetboul V, Tessier D, Nicole A, Jacquet J, Carlos C, Retortillo J, Fayolle P, Pouchelon JL. Minimally invasive patent ductus arteriosus occlusion in 5 dogs. Vet Surg 2004; 33: 309-313.

상세보기
Brissot HN, Dupre GP, Bouvy BM, Paquet L. Thoracoscopic treatment of bullous emphysema in 3 dogs. Vet Surg 2003; 32: 524-529.

상세보기
Cano I, Anton-Pacheco JL, Garcia A, Rothenberg S. Videoassisted thoracoscopic lobectomy in infants. Eur J Cardiothorac Surg 2006; 29: 997-1000.

상세보기
Chambers B, Tyrrell D, Laksito M, Anderson G, Yates G. Thoracoscopic-assisted lung lobectomy in the dog: a pilot cadaveric study examining the influence of assisted portal position on pulmonary exposure. Aust Vet Pract 2012; 42: 314-320.

상세보기
Daly CM, Swalec-Tobias K, Tobias AH, Ehrhart N. Cardiopulmonary effects of intrathoracic insufflation in dogs. J Am Anim Hosp Assoc 2002; 38: 515-520.

상세보기
Garcia F, Prandi D, Pena T, Franch J, Trasserra O, de la Fuente J. Examination of the thoracic cavity and lung lobectomy by means of thoracoscopy in dogs. Can Vet J 1998; 39: 285-291.

상세보기
Gicking J, Aumann M. Lung lobe torsion. Compend Contin Educ Vet 2011; 33: E4.
Hansen HJ, Petersen RH. Video-assisted thoracoscopic lobectomy using a standardized three-port anterior approach -The Copenhagen experience. Ann Cardiothorac Surg 2012; 1: 70-76.

상세보기
Laksito M, Chambers B, Yates G. Thoracoscopic-assisted lung lobectomy in the dog: report of two cases. Aust Vet J 2010; 88: 263-267.

상세보기
Lansdowne JL, Monnet E, Twedt DC, Dernell WS. Thoracoscopic lung lobectomy for treatment of lung tumors in dogs. Vet Surg 2005; 34: 530-535.

상세보기
Lansdowne JL, Mehler SJ, Boure LP. Minimally invasive abdominal and thoracic surgery: techniques. Compendium Contin Educ Vet 2012; 34: E2.
Larue SM, Withrow SJ, Wykes PM. Lung resection using surgical staples in dogs and cats. Vet Surg 1987; 16: 238-240.

상세보기
Liem NT. Thoracoscopic approach in management of congenital diaphragmatic hernia. Pediatr Surg Int 2013; 29: 1061-1064.

상세보기
Lin J, Iannettoni MD. The role of thoracoscopy in the management of lung cancer. Surg Oncol 2003; 12: 195-200.

상세보기
Liptak J, Monnet E, Dernell W, Withrow S. Pulmonary metastatectomy in the management of four dogs with hypertrophic osteopathy. Vet Comp Oncol 2004; 2: 1-12.

상세보기
Mayhew PD, Friedberg JS. Video-assisted thoracoscopic resection of noninvasive thymomas using one-lung ventilation in two dogs. Vet Surg 2008; 37: 756-762.

상세보기
Mayhew PD, Culp WT, Pascoe PJ, Kass PH, Johnson LR. Evaluation of blind thoracoscopic-assisted placement of three double-lumen endobronchial tube designs for one-lung ventilation in dogs. Vet Surg 2012; 41: 664-670.

상세보기
McCarthy TC, Monnet E. Diagnostic and operative thoracoscopy. In: Veterinary endoscopy for the small animal practitioner. St. Louis: Elsevier Saunders. 2005: 229-278.
McKenna RJ. The current status of video-assisted thoracic surgery lobectomy. Chest Surg Clin N Am 1998; 8: 775-785.
Monnet E. Lungs. In: Veterinary surgery: small animal. St.Louis: Elsevier Saunders. 2012: 1752-1768.
Monnet E. Thoracoscopic and thoracoscopically assisted lung lobectomy. In: Small animal endoscopy, 3rd ed. St. Louis: Elsevier Mosby. 2011: 496-501.
Mosing M. Use of an endobronchial blocker and selective lung ventilation to aid surgical removal of a lung lobe abscess in a dog. Case Reports in Veterinary Medicine 2012. Article ID 926803, 4 pages, doi:10.1155/2012/926803.

상세보기
Parekh H, Rusch V, Bains M, Downey R, Ginsberg R. VATS port site recurrence: a technique dependent problem. Ann Surg Oncol 2001; 8: 175-178.

상세보기
Pelaez MJ, Jolliffe C. Thoracoscopic foreign body removal and right middle lung lobectomy to treat pyothorax in a dog. J Small Anim Pract 2012; 53: 240-244.

상세보기
Pizzi R. Thoracoscopy. In: Clinical Manual of Small Animal Endosurgery. West Sussex: Blackwell. 2012: 169-208.
Seong YW, Kang CH, Kim JT, Moon HJ, Park IK, Kim YT. Video-assisted thoracoscopic lobectomy in children: safety, efficacy, and risk factors for conversion to thoracotomy. Ann Thorac Surg 2013; 95: 1236-1242.

상세보기
Spranklin DB, Gulikers KP, Lanz OI. Recurrence of spontaneous lung lobe torsion in a pug. J Am Anim Hosp Assoc 2003; 39: 446-451.

상세보기
Tobias KM. Surgical stapling devices in veterinary medicine: A review. Vet Surg 2007; 36: 341-349.

상세보기

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