Biópsia pulmonar incisional por toracoscopia paraxifoide transdiafragmática com dois portais em cães

Abstract

There are many respiratory diseases in small animals, as well as the possibilities of diagnoses, as laboratory and radiographic exams, bronchoalveolar lavage and biopsies. This research aimed at assessing the results of transdiaphragmatic paraxiphoid thoracoscopies in pulmonary biopsies of thirteen clinically healthy dogs. Under general anesthesia, each dog was insufflated with 30ml kg -1 of air in each hemithorax; two trocars were placed between the xiphoid appendix and the costal arch through the diaphragm. An endoscope was introduced by the first portal; while the second portal was used to allow access to the nippers in the biopsy forceps. Then, these nippers were removed and replaced by chest tube drainage. During the procedures, respiratory frequency, heart rate, oxygen saturation, arterial pressure and central venous pressure (CVP), hemogasometric parameters were checked. Within 48 hours after the surgery, drains were or drain was removed, with minimal production of air and/or liquid. In conclusion, this is a fast and safe technique, which is free of trans and post surgical complications, thus allowing the collection of sufficient material for pulmonary histological evaluation.

Lung biopsy with guillotine cutting needle and biopsy forceps though transdiaphragmatic thoracoscopy in dogs with pulmonary alterations

“…The option to insert the second portal through transdiaphragmatic paraxiphoid access guided by endoscopic intercostal visualization was safe, without the occurrence of iatrogenic lesion in any of the 14 dogs of this study, corroborating the reports of Pigatto et al (2008) and Basso et al (2010). However, it is noteworthy that in these studies the pneumothorax was instituted by insufflation of the thoracic cavity with CO 2 which facilitated diaphragm distension and the transdiaphragmatic paraxiphoid trocar insertion safe.…”

“…The choice for transdiaphragmatic paraxiphoid access for the insertion of the endoscope allowed extensive exploration of the thoracic cavity in both hemithorax and excellent visualization of the pulmonary parenchyma, corroborating with the studies of Twedt (2002), Pigatto et al (2008) and Basso et al (2010). It is known that both dogs and cats may present communication between the hemithorax physiologically (Orton 1998).…”

“…However, definitive diagnosis is often possible only by histological examination (Withrow 2013). Samples for this examination can be obtained by biopsy performed by thoracotomy, thoracoscopy or percutaneous with guillotine cutting needle (Wilson & Dungworth 2002, Baez & Sorenmo 2004, Basso et al 2010.…”

Cloreto de sódio a 0,9%, adicionado ou não de dexametasona, intrapleural, na prevenção de aderências pulmonares após toracotomia intercostal em cães

“…Quinze dias após a intervenção cirúrgica, foi realizada toracoscopia, conforme descrito em BASSO et al (2010), para inspeção de aderências, teste do grau de resistência e obtenção de amostras para análise histológica. O portal para introdução da óptica teve localização paraxifóide e, para introdução da pinça saca-bocados, intercostal ipsolateral ao Ciência Rural, v.43, n.8, ago, 2013. hemitórax a ser explorado.…”

Cervical and transdiaphragmatic paraxiphoid thoracoscopy in dogs: evaluation of respiratory response and blood pressure

“…Among the thoracoscopy methods that have been described, there are the cervical, intercostal and transdiaphragmatic paraxiphoid methods ( BASSO et al, 2010). The same authors assert that the transdiaphragmatic paraxiphoid method is useful for partial pericardiectomy procedures in patients with pericardial effusion.…”