Thoracotomy

Question 1

Pilot et al VetSurg 2022- Comparing sternotomy closure with suture vs ortho wire, difference in closure related complications?
Risk factors for complications?

Answer 1

• Complication rate 14.1% - 20/115 wire and 17/148 suture
• Suture had a 2.3% low risk of complications than wire
  -Increased dog size increased risk (regardless of closure)

Question 2

Diamond et al VetSurg 2021- Variable angle endoscopy (VAE) vs fixed angle endoscopy (FAE) for thorascopic explore
Which had the shortest time to identify structures?
Which was less likely to be able to identify the pre-determined structures?

Answer 2

• VAE
• FAE

Question 3

Nutt et al VetSurg 2021- Comparing muscle-sparing and standard lateral thoracotomy:
Which showed the lowest PO lameness?
Which showed the lowest PO pain?

Answer 3

• All had lower symmetry indexs at day 3 vs pre-op - 3.1 fold greater after standard lateral thoracotomy
• Muscle-sparing group was less painful on day 1

Question 4

Gordo et al JSAP 2020
What was the success rate of the use uniportal thoracoscopic surgery using a single-incision subxiphoid approach?
Complication rate?

Answer 4

-50%
-0%

Question 5

Carroll et al JAVMA 2024- For the thoracoscopic removal of cranial mediastinal masses what was the:
Conversion rate?
Survival to discharge?
Long term outcome?

Answer 5

• 8%; more likely with larger median maximal diameter of tumors on CT (>4.7 cm)
• 100%
• strongly dependent on the presence of myasthenia gravis or megaesophagus; 1102 days - with myasthenia gravis 182 days

Question 6

Weiland et al JAVMA 2024- Use of a parastenal thoracotomy via rib disarticulation at the stenocostal joint
Survival rate?
Risk factor for non-survival?

Answer 6

-94.6% survived surgery; 89.2% survived to discharge
-The presence of a thoracostomy tube was decreased changes of survival by 5.7% for every hour in place

Question 7

Levine and Scharf Vet Surg 2024- Compared intercostal thoracoscopic pericardectomy vs transdiaphragmatic paraxiphoid approach.
Difference in surgical time?
Ability to exteriorize the heart from pericardium?
Size of pericardial fragments which remained?
Cardiac exposure score?
Operative visibility score?

Answer 7

• No difference
• No difference
• Larger with traditional approach
• Higher with traditional approach
• Higher with traditional approach