Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Portal Placement for Thoracoscopic Right Middle Lung Lobectomy with One-Lung Ventilation in Beagle Dogs

비글견에서 편측성 분리폐 환기를 이용한 흉강경 우중폐엽 절제술을 위한 포트 위치

  • Park, Ji Young (College of Veterinary Medicine.Research institute of Veterinary Medicine, Chungnam National University) ;
  • Lee, Hae-Beom (College of Veterinary Medicine.Research institute of Veterinary Medicine, Chungnam National University) ;
  • Jeong, Seong Mok (College of Veterinary Medicine.Research institute of Veterinary Medicine, Chungnam National University)
  • 박지영 (충남대학교 수의과대학.동물의과학연구소) ;
  • 이해범 (충남대학교 수의과대학.동물의과학연구소) ;
  • 정성목 (충남대학교 수의과대학.동물의과학연구소)
  • Accepted : 2015.02.14
  • Published : 2015.02.28
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Abstract

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.

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.

Keywords

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