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      The feasibility and effectiveness of thoracoscopic transdiaphragmatic approach for lung biopsy in rabbits. A randomized study 1

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          Abstract

          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.

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          Most cited references25

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          Prevalence of chronic pain after pulmonary resection by thoracotomy or video-assisted thoracic surgery.

          The prevalence and severity of chronic pain after video-assisted thoracic surgery for pulmonary resection remains to be defined. Three hundred forty-three of 391 consecutive patients 3 to 31 months after pulmonary resection by lateral thoracotomy (n = 165) or video-assisted thoracic surgery (n = 178) responded to a questionnaire aimed at comparing the relative occurrence of chronic postoperative pain after video-assisted thoracic surgery and lateral thoracotomy approaches for pulmonary resection. Patients less than 1 year after operation (video-assisted thoracic surgery = 142; thoracotomy = 97) and more than 1 year after operation (video-assisted thoracic surgery = 36; thoracotomy = 68) were analyzed as individual cohorts. Chronic pain was assessed by questioning patients about the presence and the intensity of discomfort on the side of the operation (using a visual analog scale) and their need for analgesic medication and the presence of ongoing limitations in shoulder function. Patients who underwent video-assisted thoracic surgery (less than 1 year from operation) had less pain and subjective shoulder dysfunction although their pain medication requirements were similar to those of thoracotomy patients less than 1 year from operation. After 1 year, there was no significant difference in these "pain related" morbidity parameters between the two surgical approach groups (video-assisted thoracic surgery or thoracotomy).
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            Thoracoscopic lung lobectomy for treatment of lung tumors in dogs.

            To report use of thoracoscopic lung lobectomy (TLL) for treatment of lung tumors (LT) in dogs. Retrospective study. Nine dogs. Dogs that had TLL for tumor removal were included. Using general anesthesia and 1-lung ventilation, TLL was performed using a 30-60 mm endoscopic gastrointestinal anastomosis stapler. If the visual field was obscured, lobe resection was completed via thoracotomy. Metastatic and primary LT were resected by thoracoscopic lobectomy in 9 dogs (6 male, 3 female; mean (+/-SD) weight, 29+/-7 kg; mean age, 10.7+/-1.9 years). Six dogs had a solitary mass and 3 dogs had 2 masses within a single lobe. The left caudal lobe was removed in 3 dogs. In 5 dogs, TLL was used alone whereas conversion to thoracotomy was required in 4 dogs because of poor visibility. There were 7 metastatic LT and 2 primary LT. Mean duration of thoracoscopic surgery was 108.8+/-30.3 minutes compared with 150.75+/-55.4 minutes in dogs requiring conversion to thoracotomy. Mean hospitalization was 3.1+/-1.3 days. Provided the visual field is not obscured, TLL can be performed effectively in dogs. Dogs with metastatic or primary LTs should be considered for TLL, particularly for small masses positioned away from the hilus in the left caudal lung lobe.
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              Assessing the Safety and Clinical Impact of Thoracoscopic Lung Biopsy in Patients with Interstitial Lung Disease.

              The clinical relevance of surgical lung biopsy in Interstitial Lung Disease (ILD) is supported in the literature. Yet most reports reflect institutional or personal bias.
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                Author and article information

                Journal
                Acta Cir Bras
                Acta Cir Bras
                acb
                Acta Cirúrgica Brasileira
                Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia
                0102-8650
                1678-2674
                03 July 2020
                2020
                : 35
                : 5
                : e202000501
                Affiliations
                [I ]MSc, Fellow PhD degree, Postgraduate Program in Science, Department of Veterinary Surgery, School of Agrarian Sciences and Veterinary Medicine (FCAV), Universidade Estadual Paulista (UNESP), Jaboticabal-SP, Brazil. Conception and design of the study; acquisition, analysis and interpretation of data; technical procedures.
                [II ]PhD, Associate Professor, Universidade Federal Rural do Rio de Janeiro (UFRRJ), Seropedica-RJ, Brazil. Acquisition of data, technical procedures.
                [III ]PhD, Veterinary Anesthesia Division, Department of Veterinary Surgery, FCAV, UNESP, Jaboticabal-SP, Brazil. Acquisition of data, technical procedures.
                [IV ]MSc, Department of Preventive Veterinary Medicine and Animal Reproduction, FCAV, UNESP, Jaboticabal-SP, Brazil. Histopathological examinations.
                [V ]MSc, Fellow PhD degree, Postgraduate Program in Science, Department of Veterinary Surgery, FCAV, UNESP, Jaboticabal-SP, Brazil. Acquisition of data, technical procedures.
                [VI ]PhD, Department of Preventive Veterinary Medicine and Animal Reproduction, FCAV, UNESP, Jaboticabal-SP, Brazil. Acquisition of data, technical procedures.
                [VII ]PhD, Full Professor, Veterinary Surgery Division, Universidade Federal do Pará (UFPA), Belem-PA, Brazil. Conception, design, intellectual and scientific content of the study.
                [VIII ]PhD, Full Professor, Department of Veterinary Surgery, FCAV, UNESP, Jaboticabal-SP, Brazil. Conception, intellectual and scientific content of the study; critical revision.
                Author notes
                Correspondence: Monica Carolina Nery Wittmaack. Departamento de Clínica e Cirurgia Veterinária, FCAV Universidade Estadual Paulista - UNESP Rua Prof. Paulo Donato Castellane, s/nº (3,15 km) 14884-900 Jaboticabal-SP Brasil Tel.: (55 16)3209-7244 wittmaackm@ 123456yahoo.com.br

                Conflict of interest: none

                Author information
                http://orcid.org/0000-0001-7191-2320
                http://orcid.org/0000-0003-2071-6930
                http://orcid.org/0000-0002-2816-1944
                http://orcid.org/0000-0001-5131-9255
                http://orcid.org/0000-0002-3912-6423
                http://orcid.org/0000-0002-3826-5317
                http://orcid.org/0000-0001-8828-8675
                http://orcid.org/0000-0002-0255-2971
                Article
                00202
                10.1590/s0102-865020200050000001
                7341988
                32638842
                c28d3ffc-2a25-452a-b106-71d0ed538078

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 January 2020
                : 19 March 2020
                : 15 April 2020
                Page count
                Figures: 3, Tables: 0, Equations: 0, References: 23
                Categories
                Original Article

                thoracic surgery, video-assisted,biopsy,lung,minimally invasive surgical procedures,rabbits

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