Thoracoscopy

Question 1

Mayhew, Vet Surg, 2015:
One-lung ventilation with or without low-pressure CO2 insufflation in cats

1. Without insufflation, what were the effects of one-lung ventilation on hemodynamic variables and oxygen delivery?
2. With low-pressure CO2 insufflation, what were the effects of one-lung ventilation on hemodynamic variables and oxygen delivery?

Answer 1

Mayhew, Vet Surg, 2015:

1. Without insufflation, there were no effects of one-lung ventilation on hemodynamic variables or oxygen delivery
2. With low-pressure CO2 insufflation, there were no effects of one-lung ventilation on hemodynamic variables, but oxygen delivery was significantly lower after left one-lung ventilation compared to the right

Question 2

Case, Vet Surg, 2015:
Spontaneous pneumothorax and pulmonary bullae

1. Conversion rate to median sternotomy?
2. Successful outcomes were achieved in what % of dogs that did not require conversion to median sternotomy vs dogs that required conversion to median sternotomy?

Answer 2

Case, Vet Surg, 2015:

1. 58% conversion rate
2. Successful outcomes were achieved in 50% of dogs that did not require conversion to median sternotomy vs 83% of dogs that required conversion to median sternotomy

Question 3

Bleakley, Vet Surg, 2015:
Lung lobectomy for primary lung tumors

1. Conversion rate to thoracotomy?
2. Differences in short-term and long-term outcomes between thoracoscopic cases and thoracotomy cases?

Answer 3

Bleakley, Vet Surg, 2015:

1. 23% conversion rate
2. No differences in short-term and long-term outcomes between thoracoscopic cases and thoracotomy cases

Question 4

Steffey, Vet Surg, 2015:
Extirpation of tracheobronchial lymph nodes

1. Complications?
2. Median % surface area of bisected lymph nodes that was affected by crush artefact?

Answer 4

Steffey, Vet Surg, 2015:

1. Complications: hemorrhage, inability to locate any tracheobronchial lymph nodes, difficulty achieving or maintaining one-lung ventilation
2. Median surface area of lymph nodes that was affected by crush artefact: 20%

Question 5

Townsend, Vet Surg, 2016:
PRAA

1. What % of dogs had an aberrant left subclavian artery?
2. Major complication rate?
3. Regurgitation resolved in what % of dogs?

Answer 5

Townsend, Vet Surg, 2016:

1. 56% had an aberrant left subclavian artery
2. Major complication rate: 22%
3. Regurgitation resolved in 50% of dogs

Question 6

MacIver, JAVMA, 2017:
Cranial mediastinal masses

1. What were the various types of cranial mediastinal masses?
2. What % of the dogs had myasthenia gravis and megaesophagus?
3. Conversion rate to open thoracic surgery?
4. MST for dogs with thymoma and concurrent myasthenia gravis and megaesophagus?
5. MST for dogs with thymoma without paraneoplastic syndromes?

Answer 6

MacIver, JAVMA, 2017:

1. 89% thymoma, 5.5% thyme anaplastic carcinoma, 5.5% HSA
2. 39% had myasthenia gravis and megaesophagus
3. 11% conversion rate
4. MST for dogs with thymoma and concurrent myasthenia gravis and megaesophagus: 20 days
5. MST for dogs with thymoma without paraneoplastic syndromes: 60 days or more

Question 7

Scott, Vet Surg, 2017:
Pyothorax in dogs

1. Conversion rate to open thoracotomy?
2. Cause(s) of pyothorax identified?

Answer 7

Scott, Vet Surg, 2017:

1. 14% conversion rate
2. Causes of pyothorax: penetrating gastric FB (14%), migrating plant material (14%), idiopathic (72%)

Question 8

Barbur, Vet Surg, 2018:

% of epicardial surface exposed with the novel thoracoscopic pericardiectomy technique vs a standard pericardial window technique?

Answer 8

Barbur, Vet Surg, 2018:

% epicardial surface exposed was increased with the novel thoracoscopic pericardiectomy technique compared to a standard pericardial window technique

Question 9

Steffey and Mayhew, Vet Surg, 2018:
Direct near-infrared fluorescent lymphography (NIRFL) for thoracic duct identification in chylothorax

1. What % of cases achieved successful NIRFL within 10mins of popliteal lymph node injection?
2. NIRFL identified small lymphatics that were not visible on CT lymphography in what % of cases?

Answer 9

Steffey and Mayhew, Vet Surg, 2018:

1. 64% of cases achieved successful NIRFL within 10mins of popliteal lymph node injection
2. NIRFL identified small lymphatics that were not visible on CT lymphography in 8% of cases

Question 10

Mitchell, Vet Surg, 2018:
Thoracic duct sealing using a bipolar vessel-sealing device in cats

What % of cats had reestablished chylous flow through the previously sealed thoracic duct at 3 months post-op, and how?

Answer 10

Mitchell, Vet Surg, 2018:

83% of cats had reestablished chylous flow through the previously sealed thoracic duct at 3 months post-op through recanalization rather than development of de novo lymphatic vessels

Question 11

Mayhew, Vet Surg, 2019:
Thoracic insufflation in cats

1. Effect of thoracic insufflation with 3mmHg and 5mmHg for 30mins on oxygen delivery and ventilation?
2. Effect of thoracic insufflation on cardiac index after 30mins at 3mmHg vs 5mmHg?
3. Working space achieved with 3mmHg vs 5mmHg of thoracic insufflation?

Answer 11

Mayhew, Vet Surg, 2019:

1. All cats tolerated thoracic insufflation with 3mmHg and 5mmHg for 30mins without oxygen desaturation, but ventilatory levels had to be increased substantially to maintain eucapnia and oxygenation
2. Cardiac index was not affected by thoracic insufflation at 3mmHg but was lower at 5mmHg
3. Working space was not different between 3mmHg and 5mmHg of thoracic insufflation

Question 12

Mayhew, Vet Surg, 2019:
Thoracic duct ligation and pericardiectomy for chylothorax

1. Conversion rate to open approach for thoracic duct ligation?
2. Conversion rate to open approach for pericardiectomy?
3. Mortality rate?
4. Pleural effusion resolved in what % of dogs that survived?
5. What % of dogs developed late recurrence of pleural effusion 12-19 months post-op?

Answer 12

Mayhew, Vet Surg, 2019:

1. 3% conversion rate for thoracic duct ligation
2. 11% conversion rate for pericardiectomy
3. Mortality rate: 10%
4. Pleural effusion resolved in 95% of dogs that survived
5. 9% developed late recurrence of pleural effusion 12-19 months post-op

Question 13

Singh, Vet Surg, 2019:
Optimization of surgical approach

1. Thoracoscopic-assisted lung lobectomy performed at the left or right 4th or 5th intercostal spaces resulted in a shorter median distance from the stapler anvil to the pulmonary hilus of which lung lobes?
2. Thoracoscopic-assisted lung lobectomy performed at which intercostal spaces resulted in a shorter median distance from the stapler anvil to the pulmonary hilus of the right caudal and accessory lung lobes?

Answer 13

Singh, Vet Surg, 2019:

1. Thoracoscopic-assisted lung lobectomy performed at the left or right 4th or 5th intercostal spaces resulted in a shorter median distance from the stapler anvil to the pulmonary hilus of the left cranial and caudal lung lobes and the right cranial and middle lung lobes
2. Thoracoscopic-assisted lung lobectomy performed at the right 5th or 6th intercostal spaces resulted in a shorter median distance from the stapler anvil to the pulmonary hilus of the right caudal and accessory lung lobes

Question 14

Carvajal, Vet Surg, 2019:
Pericardiectomy and pericardioscopy for idiopathic pericardial effusion

1. MST for dogs without evidence of masses, nodules and/or adhesion vs dogs with abnormalities identified during pericardioscopy?
2. MST was not different between dogs with a histopathologic diagnosis of neoplasia and dogs with a histopathologic diagnosis of pericarditis - true or false?

Answer 14

Carvajal, Vet Surg, 2019:

1. MST: not reached for dogs without evidence of masses, nodules and/or adhesion vs 66 days for dogs with abnormalities identified during pericardioscopy
2. True