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Balsa IM. Advances in Minimally Invasive Procedures of the Thoracic Cavity. Vet Clin North Am Small Anim Pract 2024; 54:697-706. [PMID: 38575454 DOI: 10.1016/j.cvsm.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
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.
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Affiliation(s)
- Ingrid M Balsa
- Department of Clinical Sciences, Oregon State University, Corvallis, OR, USA; Carlson College of Veterinary Medicine, 172 Magruder Hall, Corvallis, OR 97331, USA.
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Lane J, Fung C, Gould E, Pfeiffer I, Fasina O, Newkirk K. Suspected Iatrogenic Seeding of Oral Melanoma Secondary to Endotracheal Intubation in a Dog. J Am Anim Hosp Assoc 2019; 55:e55405. [PMID: 31099603 DOI: 10.5326/jaaha-ms-6756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 10 yr old castrated male pug was presented with a 3 day history of intermittent dyspnea, cough, inappetence, and inability to breathe while sleeping. He had previously received hypofractionated radiation therapy for an amelanotic oral malignant melanoma (OMM) 7 mo prior to presentation. At presentation, the dog was gasping and dyspneic. Oral examination identified the OMM on the right hard palate. Thoracic radiographs revealed an angular soft-tissue opacity within the trachea just distal to the thoracic inlet. No evidence of pulmonary metastatic disease was seen. Tracheoscopy identified a pedunculated, nonpigmented mass within the lumen of the distal trachea near the carina. Treatment options were presented to the owners and included tracheal stenting or tracheal resection and anastomosis. Because of the poor prognosis, the owners elected humane euthanasia. Postmortem examination confirmed the presence of melanoma in the distal trachea; no other sites of OMM metastasis were identified. The cause of OMM development in the distal trachea in this case is suspected to have resulted from mechanical tumor cell seeding during endotracheal tube placement for general anesthesia 7 mo prior to presentation. Despite the reported rarity of mechanical tumor seeding, this potential complication warrants consideration in dogs with OMM.
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Affiliation(s)
- Jeanne Lane
- From the Department of Small Animal Clinical Sciences (J.L., C.F., E.G., I.P.), and Department of Biomedical and Diagnostic Sciences (O.F., K.N.), College of Veterinary Medicine, University of Tennessee Knoxville, Knoxville, Tennessee
| | - Canny Fung
- From the Department of Small Animal Clinical Sciences (J.L., C.F., E.G., I.P.), and Department of Biomedical and Diagnostic Sciences (O.F., K.N.), College of Veterinary Medicine, University of Tennessee Knoxville, Knoxville, Tennessee
| | - Emily Gould
- From the Department of Small Animal Clinical Sciences (J.L., C.F., E.G., I.P.), and Department of Biomedical and Diagnostic Sciences (O.F., K.N.), College of Veterinary Medicine, University of Tennessee Knoxville, Knoxville, Tennessee
| | - Isabella Pfeiffer
- From the Department of Small Animal Clinical Sciences (J.L., C.F., E.G., I.P.), and Department of Biomedical and Diagnostic Sciences (O.F., K.N.), College of Veterinary Medicine, University of Tennessee Knoxville, Knoxville, Tennessee
| | - Olufemi Fasina
- From the Department of Small Animal Clinical Sciences (J.L., C.F., E.G., I.P.), and Department of Biomedical and Diagnostic Sciences (O.F., K.N.), College of Veterinary Medicine, University of Tennessee Knoxville, Knoxville, Tennessee
| | - Kim Newkirk
- From the Department of Small Animal Clinical Sciences (J.L., C.F., E.G., I.P.), and Department of Biomedical and Diagnostic Sciences (O.F., K.N.), College of Veterinary Medicine, University of Tennessee Knoxville, Knoxville, Tennessee
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Michelotti KP, Youk A, Payne JT, Anderson J. Outcomes of dogs with recurrent idiopathic pericardial effusion treated with a 3-port right-sided thoracoscopic subtotal pericardiectomy. Vet Surg 2019; 48:1032-1041. [PMID: 31042303 DOI: 10.1111/vsu.13223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 03/19/2019] [Accepted: 04/09/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe a 3-port right-sided thoracoscopic subtotal pericardiectomy (TSP) to treat dogs with recurrent idiopathic pericardial effusion (RIPE) and report their long-term survival. STUDY DESIGN Retrospective case series. ANIMALS Sixteen client-owned dogs. METHODS Medical records were searched for dogs with idiopathic pericardial effusion that recurred after 1 or more pericardiocenteses and treated with a 3-port right-sided technique (1 subxiphoid camera port and 2 instrument ports on the right side of the dog). Follow-up consisted of direct examination or communication with referring veterinarians or owners. RESULTS Thoracoscopic subtotal pericardiectomy was successfully completed in all dogs, with no surgical complications. The median duration of postoperative follow-up was 191.5 days (range, 5-1345). The median survival time (MST) after surgery was 365 days (range, 5-1345); MST of dogs with a histopathological diagnosis of neoplasia (n = 4) was 76 days, whereas dogs with no evidence of neoplasia had an MST of 367 days (n = 12, P = .14). Recurrent pleural effusion was the ultimate cause of death or reason for euthanasia in 8 of 16 dogs. CONCLUSION The technique described here resulted in similar surgical times and outcomes for dogs undergoing TSP for RIPE compared with previous studies. Neoplasia was identified in 4 of 16 dogs. CLINICAL SIGNIFICANCE Thoracoscopic subtotal pericardiectomy can be readily performed with only 2 instrument ports, both on the same side of the dog, and without 1-lung ventilation. Recurrent pleural effusion led to the death of half of the dogs in this series.
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Affiliation(s)
- Kurt P Michelotti
- Small Animal Surgery Department, Pittsburgh Veterinary Specialty and Emergency Center, Pittsburgh, Pennsylvania
| | - Ada Youk
- Small Animal Surgery Department, Pittsburgh Veterinary Specialty and Emergency Center, Pittsburgh, Pennsylvania
| | - John T Payne
- Small Animal Surgery Department, Pittsburgh Veterinary Specialty and Emergency Center, Pittsburgh, Pennsylvania
| | - Jonathan Anderson
- Small Animal Surgery Department, Pittsburgh Veterinary Specialty and Emergency Center, Pittsburgh, Pennsylvania
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Use of Minimally Invasive Surgery in the Diagnosis and Treatment of Cancer in Dogs and Cats. Vet Sci 2019; 6:vetsci6010033. [PMID: 30897763 PMCID: PMC6466197 DOI: 10.3390/vetsci6010033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 12/31/2022] Open
Abstract
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.
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O'Connell E, Harper A, Blundell R, Batchelor D. Paraneoplastic immune-mediated neutropenia in a dog following thymoma excision with later development of metastatic thymic carcinoma treated with toceranib phosphate. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2017-000548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A thymoma was an incidental finding in a seven-year-old, female neutered, crossbred dog referred for an acute hepatopathy. Excision of the thymoma was performed via median sternotomy, and 11 weeks later the dog presented with severe neutropenia. The bone marrow was hypercellular, and paraneoplastic immune-mediated neutropenia was diagnosed following exclusion of other causes. The neutrophil count increased to normal within seven days of treatment with prednisolone, which was subsequently tapered. A caudal mediastinal mass was documented 17 months following initial thymoma excision, and pleural and mediastinal metastases were evident on CT. Cytology was consistent with carcinoma. Following the prescription of toceranib phosphate, there was stable disease on CT at eight weeks and six months. At 12 months there was severe locoregional progression and the dog died nine days thereafter. Postmortem examination showed diffuse metastatic carcinoma of the caudal mediastinum, parietal pleura and diaphragm, and histopathology/immunohistochemistry was most consistent with thymic carcinoma.
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