Thoracoscopic Lung Lobectomy for Treatment of Lung Tumors in Dogs

Advances in Minimally Invasive Procedures of the Thoracic Cavity

Significant advances in veterinary minimally invasive surgeries and procedures have occurred in the past 10 years. These advances have been allowed due to continual research into optimizing working space through one-lung ventilation techniques and carbon dioxide insufflation. Additionally, minimally invasive surgery enthusiasts have joined forces with interventionalists and, in many cases, physicians to push the boundaries, minimize pain, suffering, and time away from owners with advances in a variety of procedures. Several larger multi-institutional retrospective studies on various disease processes allow veterinarians and owners to understand that minimally invasive approaches allow for outcomes comparable to traditional open surgery and, in some cases, may now be considered the standard of care in canine and feline patients.

Augmenting Veterinary Minimally Invasive Surgery: Evidence-based Review of Foundational and Novel Devices and Technology

Veterinary minimally invasive surgery continues to grow as a specialty. With increasing experience in this field, comes improved accessibility as well as progressive complexity of procedures performed. Advancement in technology has been both a response to the growth and a necessary driver of continued refinement of this field. Innovative research leading to advancements in surgical equipment has led to the development of novel image acquisition platforms, cannulas, smoke evacuation systems, antifog devices, instrumentation, and ligating/hemostatic devices. These innovations will be reviewed and potential clinical applications are discussed.

Evaluation of long-term outcome after lung lobectomy for canine non-neoplastic pulmonary consolidation via thoracoscopic or thoracoscopic-assisted surgery in 12 dogs

OBJECTIVE

To report outcomes of thoracoscopic (TL) and thoracoscopic-assisted lung lobectomy (TAL) for treatment of non-neoplastic pulmonary consolidation (PC) in dogs.

STUDY DESIGN

Retrospective case series.

ANIMALS

Twelve client-owned dogs.

METHODS

The medical records of 12 dogs that underwent TL or TAL for PC at 3 veterinary institutions between 2011 and 2020 were reviewed. Signalment, history, physical examination, diagnostics, days in hospital, anesthetic and procedure times, intraoperative/postoperative complications, conversion rates, duration of indwelling thoracic drain, and long-term outcomes were recorded.

RESULTS

Nine patients underwent a TL approach and 3 underwent TAL. In those that underwent TL, conversion to an intercostal thoracotomy was performed in 4 out of 9 dogs. Conversion was performed due to adhesions (n = 3) or poor visualization (1). Histopathologic examination was consistent with pneumonia due to an infectious process (n = 10), bronchioalveolar malformation with abnormal cilia (1), and left-sided cardiac insufficiency vs. pulmonary alveolar proteinosis (1). The mean duration of hospital stay was 4 days (range, 1-6 days). Complications occurred postoperatively in 7 dogs and included self-limiting hemorrhage (n = 3), self-resolving pneumothorax (2), incisional dehiscence (1), and severe dyspnea in a brachycephalic breed leading to euthanasia (1). For the 11 dogs that survived the perioperative period, there was no evidence of recurrence with a median follow up of 24 months (range, 5-120 months).

CONCLUSION

Thoracoscopic (TL) and thoracoscopic-assisted lung lobectomy (TAL) is a reasonable surgical approach in select dogs with PC.

CLINICIAL RELEVANCE

Conversion rates were higher than those historically reported for dogs undergoing thoracoscopic lung lobectomy for primary lung tumors.

Complications and outcomes of thoracoscopic-assisted lung lobectomy in dogs

OBJECTIVE

To describe complications and outcomes of dogs undergoing thoracoscopic-assisted (TA) lung lobectomy.

STUDY DESIGN

Multi-institutional, retrospective study.

ANIMALS

Client-owned dogs (n = 30).

METHODS

Medical records of dogs that underwent TA lung lobectomy were reviewed. Signalment, bodyweight, clinical signs, imaging findings, surgical variables, complications, and short-term/long-term outcome were assessed. Thoracoscopic-assisted lung lobectomy was performed with a mini-thoracotomy.

RESULTS

Twelve intraoperative complications were recorded in 11 dogs, 6 requiring conversion to open thoracotomy. Reasons for conversion were reported in 5/6 dogs and included adhesions (2), difficultly manipulating the lesion through the mini-thoracotomy (2), and acute oxygen desaturation (1). One lung ventilation was successful in 4 of the 7 dogs in which this was attempted. A linear stapling device (DST series Medtronic, Minneapolis, Minnesota) was used for lung lobe ligation in 14 dogs. Twenty-three dogs underwent surgery for a neoplastic lesion, with 19 of these being carcinoma. The median lesion size was 4.3 cm (range 1-10 cm); margins were clean, except in 1 dog. Complications were documented in 8 dogs prior to discharge, 5 of these being classified as mild. Twenty-nine dogs were discharged at a median of 47 h postoperatively (range 24-120 h). Death was reported in 9 dogs, with a median survival time of 168 days (range 70-868 days).

CONCLUSION

Thoracoscopic-assisted lung lobectomy was achieved with few major complications in the population reported here. Dogs were able to be discharged from hospital quickly, with most surviving beyond the follow-up period.

CLINICAL SIGNIFICANCE

Thoracoscopic-assisted lung lobectomy may be considered to facilitate the excision of larger pulmonary lesions or to treat smaller dogs, in which a thoracoscopic excision may be technically more challenging.

Autologous blood pleurodesis for surgical pneumothorax and outcome with multimodal cancer treatment in a dog with primary pulmonary mast cell tumor

A dog underwent lung lobectomy for removal of a mass. Histopathology was consistent with narrow resection of a mast cell tumor. Postoperative pneumothorax was successfully treated using autologous blood pleurodesis. Progression of disease despite adjunctive treatment with several chemotherapetutic agents and radiation therapy resulted in euthanasia approximately 4 months postoperatively.

Thoracoscopic treatment of persistent right aortic arch in dogs with and without one lung ventilation

OBJECTIVE

To evaluate thoracoscopic treatment of persistent right aortic arch (PRAA) in dogs with and without the use of one lung ventilation (OLV).

STUDY DESIGN

Retrospective cohort study.

ANIMALS

Twenty-two (client-owned and shelter) dogs diagnosed with PRAA.

METHODS

Medical records were reviewed retrospectively and intraoperative and immediate postoperative data were compared between dogs that underwent thoracoscopic treatment of PRAA with (OLV+) and without (OLV-) OLV.

RESULTS

Ten of the 12 dogs in the OLV+ group and 7/10 dogs in the OLV- group had their left ligamentum arteriosum successfully ligated during thoracoscopy. Median surgical time, surgery complications, anesthesia complications, and rate of conversion to an open thoracotomy due to limited visualization or surgical complications were similar between the two groups.

CONCLUSION

Thoracoscopic treatment of PRAA can be performed with or without OLV. Surgical time, intraoperative complications, and conversion rates were similar between dogs that underwent thoracoscopic treatment of PRAA with and without OLV. OLV may not have contributed to improved visualization in this group of dogs.

CLINICAL SIGNIFICANCE (OR IMPACT)

The use of OLV is safe during thoracoscopic treatment of PRAA. OLV did not appear to provide significant benefits in this case series and thoracoscopic treatment of PRAA in dogs may be performed successfully with or without the use of OLV.

Resorbable self-locking device for canine lung lobectomy: A clinical and experimental study

OBJECTIVE

To test the feasibility of a resorbable self-locking device for sealing of lung tissue in lung lobectomy in experimental dogs and dogs with pulmonary mass, and to study its resorption with CT.

STUDY DESIGN

Experimental study and clinical case series.

ANIMALS

Five beagles in the experimental group; six canine patients with a pulmonary mass in the clinical group.

METHODS

In both groups, an intercostal incision into thorax was performed. A resorbable self-locking device, LigaTie, was applied at the hilum of left cranial lobe in the experimental group and the affected lobe in the clinical group. Each lobe was removed by cutting the tissue just distal to the device. Video-assisted thoracic surgery was used in the experimental group; postoperative diagnostic imaging was repeated monthly until the device was not apparent on CT.

RESULTS

Application of LigaTie was feasible for lung lobectomy in all dogs. The device enabled en bloc ligation of the hilum of the affected lobe including the pulmonary arteries and veins and lobular bronchus. No air leakage from the resection stump was observed in any dog. Trace of the device on CT images gradually decreased and was undetectable at 4 months postoperatively in experimental dogs.

CONCLUSION

This study suggested that the resorbable self-locking device may be used for sealing of airways in complete lung lobectomy.

CLINICAL RELEVANCE

The resorbable self-locking device is suggested to be useful for canine lung lobectomy and may facilitate thoracoscopic lung lobectomy. Further investigations on its clinical application in small animal surgery are warranted.

Ligation of the ligamentum arteriosum and aberrant left subclavian artery in five dogs in which persistent right aortic arch had been diagnosed

OBJECTIVE

To determine and report the diagnosis, treatment, and outcome in dogs with persistent right aortic arch (PRAA) with an aberrant left subclavian artery (ALS) that underwent thoracoscopic surgery.

ANIMALS

Dogs with PRAA and an ALS (n = 5).

STUDY DESIGN

Short case series.

METHODS

Medical records were reviewed from 2014 to 2019. Dogs that underwent thoracoscopy for PRAA with an ALS at an academic referral hospital were included. Signalment, clinical signs, diagnostic imaging, surgical approach, complications, and short- and long-term outcomes were recorded.

RESULTS

Persistent right aortic arch with an ALS was identified in five dogs. Dogs initially underwent a three-port intercostal thoracoscopic approach, and an intercostal thoracotomy was performed in converted cases. In all five dogs, the ligamentum arteriosum (LA) and ALS were divided; three were performed by a thoracoscopy alone. Two cases were converted because of poor exposure (1) and requirement to temporary occlude an ALS (1). The ALS was ligated and divided in all dogs without apparent negative effects. No intraoperative or postoperative complications occurred. Four dogs had resolution of regurgitation, three of which required diet modification. One dog had reported regurgitation when it was excited. Median follow-up was 188 days (range, 150-1133).

CONCLUSION

Ligation and division of both the LA and the ALS in all dogs in this case series was safe and allowed for improvement in clinical signs and good to excellent long-term outcomes. In addition, both thoracoscopy and thoracotomy were used safely and successfully for ligation and transection of the LA and ALS in all dogs.

The feasibility and effectiveness of thoracoscopic transdiaphragmatic approach for lung biopsy in rabbits. A randomized study

PURPOSE

To assess the feasibility of thoracoscopic transdiaphragmatic approach for biopsy of all lung lobes and to determine the optimal intercostal space (ICS) for biopsy of each lung lobe.

METHODS

Ten rabbits were positioned in dorsal recumbency. Total thoracoscopy lung biopsy was made combined transdiaphragmatic approach and right ICS approaches. A camera port was made in the transdiaphragmatic approach and the instrument port was made of ICS 7 and ICS 9. A pre tied loop ligature was placed to performed a caudal lung lobe biopsy and to simulate biopsies of the others lung lobes.

RESULTS

Biopsy of the cranial aspect of the right caudal lung lobe was performed at ICS 9. Simulated biopsy of the accessory lung lobe was performed at ICS 9. Simulated lung biopsy of the right cranial and middle lung lobes was performed at ICS 7. The caudal and dorsal aspect of the right caudal lung lobe was not visualized by telescope at transdiaphragmatic approach, and biopsy was not performed.

CONCLUSIONS

Thoracoscopic transdiaphragmatic approach for lung lobes biopsies was a feasible technique, except for the caudal aspect of the right caudal lung lobe. An ideal intercostal port for biopsy of each right lung lobe was determined.

Cadaveric evaluation of fluoroscopy-assisted placement of one-lung ventilation devices for video-assisted thoracoscopic surgery in dogs

OBJECTIVE

To evaluate the feasibility of fluoroscopy-assisted placement of one-lung ventilation (OLV) devices in dogs.

STUDY DESIGN

Experimental study.

SAMPLE POPULATION

Canine cadavers (n = 8) weighing between 20.2 and 37.4 kg.

METHODS

Thoracoscopic access with a two-port approach was established to evaluate bilateral lung ventilation patterns. Advancement of a left-sided Robertshaw double-lumen endobronchial tube (DLT) and the EZ-blocker (EZ) were evaluated under direct fluoroscopic guidance. Each dog also underwent bronchoscopy-assisted placement of an Arndt endobronchial blocker (EBB). Time to initial placement, success of creating complete OLV (after initial placement attempt and after up to two repositionings), and ease of placement score were recorded. Device position was evaluated bronchoscopically after each fluoroscopy-assisted placement attempt.

RESULTS

Time to initial placement was significantly shorter for EZ than for DLT and EBB. The rate of successful placement after up to two repositioning attempts was 87.5%, 87.5%, and 100.0% on the right and 87.5%, 100.0%, 100.0% on the left for DLT, EZ, and EBB, respectively, and was not different between devices. Ease of placement scores were significantly higher for DLT compared with EZ and EBB on both the left and the right sides.

CONCLUSION

Fluoroscopy-assisted placement of DLT and EZ appears feasible in canine cadavers. EZ-blocker placement was efficient and technically easier than DLT, but positioning must be adapted for dogs. Bronchoscopy-assisted placement of EBB remains highly successful.

CLINICAL SIGNIFICANCE

Fluoroscopy-assisted placement of EZ and DLT is a useful alternative to bronchoscopy-assisted placement of these OLV devices.

Video-assisted thoracic surgery anatomical lobectomy for a primary lung tumor in a dog

A female Bernese Mountain Dog was diagnosed with a right middle lung lobe mass. The dog was positioned in a left lateral recumbency and one-lung ventilation was used under general anesthesia. Video-assisted thoracic surgery anatomical lobectomy was performed with 4 cm small thoracotomy and two 6-mm ports. Pulmonary vessels and bronchus were dissected and isolated individually at the hilum of the right middle lung lobe. Pulmonary vessels were ligated and were coagulated and transected using a vessel sealing device. The bronchus was ligated and transected. The mass in the right middle lung lobe was removed with a clean margin and without complications. Video-assisted thoracic surgery anatomical lobectomy was used to successfully remove a primary lung tumor in a dog.

Use of Minimally Invasive Surgery in the Diagnosis and Treatment of Cancer in Dogs and Cats

Surgical management of neoplastic disease is common in veterinary medicine. Minimally invasive surgery (MIS) has gained widespread acceptance by veterinary surgeons and is experiencing rapid growth and frequency of use. Many neoplastic diseases in the abdomen and thorax of dogs and cats can be treated as effectively with MIS as with traditional open surgery. Additionally, MIS allows for less invasive options for organ biopsy in cancer patients either for initial diagnosis or for staging to inform prognosis and treatment. Despite the recent increase in MIS, additional research is required to further characterize the benefits to oncology patients and to ensure that surgical oncologic principles and patient outcomes are not compromised by the use of MIS.

Optimization of surgical approach for thoracoscopic-assisted pulmonary surgery in dogs

OBJECTIVE

To determine the optimal intercostal space (ICS) to perform thoracoscopic-assisted lung lobectomy.

STUDY DESIGN

Cadaveric study.

ANIMALS

Six mature, medium-sized canine cadavers.

METHODS

Cadavers were placed in right or left lateral recumbency. A 15-mm thoracoscopic cannula was inserted in the middle third of the 9th or 10th ICS. A wound retraction device was placed into a 7-cm minithoracotomy incision created in the middle third of the 4th-7th ICS on the left side and the 4th-8th ICS on the right side. The pulmonary ligaments were sectioned by using a combined intracorporeal and extracorporeal technique. Each lung lobe was sequentially withdrawn from the wound retraction device at the respective ICS and side. A thoracoabdominal stapler was positioned to simulate lung lobectomy, and the distance from the stapler anvil to the hilus was measured.

RESULTS

Simulated thoracoscopic-assisted lung lobectomy performed at left or right ICS 4 and 5, compared with other ICS evaluated, resulted in a significantly shorter median distance from the stapler anvil to the pulmonary hilus of the left cranial and caudal lung lobes and right cranial and middle lung lobes, respectively (all P < .05). Lobectomy at right ICS 5 or 6 resulted in a significantly shorter median distance from the stapler anvil to the pulmonary hilus of the right caudal and accessory lung lobes, respectively (both P < .05).

CONCLUSION

These data may inform minithoracotomy positioning to optimize tumor margin excision during thoracoscopic-assisted lung lobectomy for treatment of pulmonary neoplasia in dogs.

CLINICAL SIGNIFICANCE

Complete lung lobectomy is possible by using the described thoracoscopic-assisted technique in normal, cadaveric lungs.

One-lung ventilation with use of a double lumen tube in two dogs; when right might be wrong

One-lung ventilation (OLV) is an anaesthetic technique utilised for improved visualisation and access of the surgical field during thoracoscopy. The authors present two cases that underwent OLV with use of a double lumen tube (DLT). The first case was intubated with endoscopic guidance for bronchial port intubation of the right mainstem bronchus. This dog experienced prolonged periods of intraoperative hypoxemia. Upon case review, it was suspected intubation of the mainstem bronchus resulted in occlusion of the right cranial lung lobe. In the second case, the DLT was placed bronchoscopically into the left mainstem bronchus with the aid of computed tomography (CT). Excellent intraoperative oxygenation was achieved. When DLTs are used in dogs, their anatomical differences from humans make them susceptible to additional lung occlusion and pulmonary shunting. Computed tomography is recommended as a fundamental addition to bronchoscopy for correct tube placement.

Comparison of the effects of isoflurane versus propofol-remifentanil anesthesia on oxygen delivery during thoracoscopic lung lobectomy with one-lung ventilation in dogs

This study compared effects of isoflurane inhalation (ISO) and propofol-remifentanil combined total intravenous anesthesia (TIVA) on oxygenation during thoracoscopic lung lobectomy with 30-min one-lung ventilation (1LV). Thoracoscopic right middle lung lobectomy was performed in ten dogs divided into ISO and TIVA groups, and cardiopulmonary parameters were measured with blood gas analysis. Throughout the study, isoflurane was inhaled up to 1.5%, and the infusion rates of propofol and remifentanil were 0.2 to 0.4 mg/kg/min and 6 to 11 µg/kg/h, respectively. Cardiac index was not affected in the ISO group, but it increased during 1LV in the TIVA group. There were significant alterations in arterial oxygen pressure, arterial oxygen saturation, oxygen content, and shunt fraction associated with 1LV in each group. However, oxygen delivery did not decrease significantly due to open chest condition, 1LV, or surgical maneuver in either group, rather it increased during 1LV in the TIVA group. All parameters showed no significant difference between groups. Pulmonary vascular resistant index was unaffected in both groups, and there was no difference between groups except in re-ventilation phase. Accordingly, the effect of both anesthetic regimens on oxygenation was not different between groups and can be used with short-term 1LV for thoracoscopic lung lobectomy in dogs.

Complications and Conversion from Endoscopic to Open Surgery

Endoscopic surgery is a rapidly expanding modality of diagnosis and treatment of small animal patients. The development of skills, equipment, and minimally invasive means of correcting complications may be of great importance in decreasing the incidence of conversion from endoscopic to open surgery; however, conversion to an open approach should never be seen as a failure. Conversion should be considered at any time that it is of the greatest benefit for the patient. This concept is important enough to warrant discussion with the owner before surgery and acceptance of the need to convert without further consultation during the procedure.

Current concepts in minimally invasive surgery of the thorax

Thoracoscopy is a technique that has been shown to decrease patient morbidity and is rapidly becoming more diversely applied for diagnostic and therapeutic interventions in veterinary medicine. This article describes the basic equipment and application of thoracoscopy in small animal surgery. The diagnostic and therapeutic applications are introduced and briefly described.

Evaluation of Video-Assisted Thoracic Surgery for Treatment of Spontaneous Pneumothorax and Pulmonary Bullae in Dogs

OBJECTIVE

To describe the operative findings and clinical outcome in dogs undergoing video-assisted thoracic surgery (VATS) for treatment of spontaneous pneumothorax and pulmonary bullae.

STUDY DESIGN

Multi-institutional retrospective case series.

ANIMALS

Dogs (n = 12) with spontaneous pneumothorax and/or pulmonary bullae.

METHODS

Medical records (2008-2013) were reviewed for signalment, clinical signs, diagnostic imaging, surgical and histopathologic findings, and outcome in 12 dogs that had VATS for treatment of spontaneous pneumothorax and pulmonary bullae. In particular, conversion to median sternotomy and surgical success were evaluated.

RESULTS

Twelve dogs had initial VATS for spontaneous pneumothorax and/or pulmonary bullae. Conversion to median sternotomy because of inability to identify a parenchymal lesion/leak was necessary in 7 (58%) dogs. VATS without conversion to median sternotomy was performed in 6 (50%) dogs. Successful surgical outcomes occurred in 5 (83%) dogs that had conversion to median sternotomy, and in 3 (50%) dogs that had VATS without conversion to median sternotomy.

CONCLUSIONS

Exploratory thoracoscopy was associated with a high rate of conversion to median sternotomy because of inability to identify leaking pulmonary lesions in dogs with spontaneous pneumothorax and pulmonary bullae. Failure to convert to a median sternotomy may be associated with recurrent or persistent pneumothorax.

Thoracoscopy in the cat: an up-and-coming diagnostic and therapeutic procedure

PRACTICAL RELEVANCE

Thoracoscopy provides a minimally invasive means of diagnosis and offers many important benefits when compared with open thoracotomy.

CLINICAL CHALLENGES

The expense of the equipment, the steep learning curve required to gain proficiency in thoracoscopic surgery, and the limitations imposed by the feline thoracic cavity, in terms of working and viewing space, are some of the challenges that have limited its uptake to date. However, it is envisaged that it will increase as a technique in feline medicine, in much the same way as laparoscopy has.

AUDIENCE

This article is directed at veterinarians currently performing open thoracic surgery and the associated aftercare who concurrently are adept at endoscopic surgery.

EVIDENCE BASE

The article draws on the small body of literature that is available on thoracoscopy in cats, which includes reports of its use for evaluation and management of undiagnosed pleural effusion, lung lobe torsion, persistent right aortic arch and chylothorax.

Use of the Ligasure vessel-sealing device for thoracoscopic peripheral lung biopsy in healthy dogs

OBJECTIVE

To evaluate the use of a bipolar vessel-sealing device for peripheral lung lobe biopsy in healthy dogs.

STUDY DESIGN

Experimental study.

ANIMALS

Mature female hound dogs (n = 6).

METHODS

Thoracoscopic access was obtained by placement of a subxiphoid telescope portal with instrument portals at the right 4-6th intercostal spaces and the left 10th intercostal space. The 10-mm Ligasure Atlas device was used to collect a biopsy specimen from the periphery of the left cranial lung lobe. Dogs were recovered from anesthesia. Histologic evaluation was used to characterize the effect of biopsy technique on pulmonary tissue. Thoracic radiography was performed at 1, 2, 4, and ∼180 days to evaluate for air leakage or other postoperative complications.

RESULTS

Lung specimens were collected without complications. Postoperatively, 1 dog had some residual pneumothorax thought to be secondary to incomplete thoracic evacuation of air postoperatively. No evidence of air leakage was detected at any time point. Histologically, specimens had 3 distinct zones: a crush zone representing the tissue within the jaws of the device, a transition zone of thermally damaged parenchyma, and beyond that a viable zone of normal parenchyma.

CONCLUSION

From these limited data, it appears that the Ligasure Atlas vessel-sealing device can be used for peripheral lung biopsy in healthy dogs. Further studies are required to evaluate the efficacy of the device in dogs with parenchymal disease.

Video-Assisted Thoracoscopic Surgery for Pneumothorax Induced by Migration of a K-Wire to the Chest

A 2 yr old female English setter dog was admitted for acute dyspnea. The dog underwent treatment of a T9T10 thoracic vertebral fracture subluxation at the authors' institution 15 mo earlier. Upon admission, a chest X-ray revealed a pneumothorax and a metallic foreign body in the left hemithorax. An emergency video-assisted thoracoscopic surgery was successfully performed to remove a 4.6-mm long Kirschner wire that migrated from the thoracic vertebral column to the thoracic cavity. The operating time was 27 min. The dog made an uneventful recovery and was discharged on the third day after surgery. Pneumothorax should be considered in patients that develop acute dyspnea and have a history of wire fixation in the thoracic vertebral column. Video-assisted thoracoscopic surgery is a safe and effective treatment of this condition.

Pre- and post-operative cardiac evaluation of dogs undergoing lobectomy and pneumonectomy

This study aimed to assess the influence of lobectomy and pneumonectomy on cardiac rhythm and on the dimensions and function of the right-side of the heart. Twelve dogs undergoing lobectomy and eight dogs undergoing pneumonectomy were evaluated preoperatively and one month postoperatively with electrocardiography and Doppler echocardiography at rest. Pulmonary artery systolic pressure (PASP) was estimated by the tricuspid regurgitation jet (TRJ) via the pulse wave Doppler velocity method. Systemic inflammatory response syndrome criteria (SIRS) were also evaluated based on the clinical and hematological findings in response to lobectomy and pneumonectomy. Following lobectomy and pneumonectomy, we predominantly detected atrial fibrillation and varying degrees of atrioventricular block (AVB). Dogs that died within seven days of the lobectomy (n = 2) or pneumonectomy (n = 1) had complete AVB. Preoperative right atrial, right ventricular, and pulmonary artery dimensions increased gradually during the 30 days (p<0.05) following pneumonectomy, but did not undergo significant changes during that same period after lobectomy. Mean PASP was 56.0 ± 4.5 mmHg in dogs having significant TRJ after pneumonectomy. Pneumonectomy, but not lobectomy, could lead to increases (p<0.01) in the SIRS score within the first day post-surgery. In brief, it is important to conduct pre- and postoperative cardiac evaluation of dogs undergoing lung resections because cardiac problems are a common postoperative complication after such surgeries. In particular, complete AVB should be considered a life-threatening complication after pneumonectomy and lobectomy. In addition, pneumonectomy appears to increase the likelihood of pulmonary hypertension development in dogs.