Single-dose antimicrobial prophylaxis in transoral surgical lung biopsy: a preliminary experience

Abstract

This study showed the feasibility of transoral thoracoscopy and surgical lung biospy in dogs. Moreover, single-dose prophylaxis with cefazoline in transoral surgical lung biopsy was found to be effective in preventing potential infection.

Comparison of hemodynamic and inflammatory changes between transoral and transthoracic thoracoscopic surgery

“…We recently published a study demonstrating the successful performance of a minor thoracic procedure via a transoral approach in a canine model [11]- [13]. In line with these findings, our present study further demonstrated the safety and efficacy of the transoral approach in hemodynamic, inflammatory conditions.…”

“…Our group previously described the utilization of transtracheal thoracoscopy in 12 dogs; we encountered 3 cases of tension pneumothorax due to inadvertent injury to the lung during creation of a tracheal access site [20]. Recently, we have made significant progress in using a transoral route for surgical lung biopsy and pericardial window creation, without major intraoperative or postoperative complications [10]- [13]. Our findings suggest that a transoral approach can be used as a novel platform for studies of NOTES for intrathoracic surgery.…”

“…The resected lung margin was reinforced with a homemade (Ethicon, Somerville, NJ, USA) endoloop ligature to prevent air leakage. The vestibular incision was then closed with a running 3-0 Vicryl suture (Ethicon, San Angelo, TX, USA) as previously described [11]- [13]. Soon after completion of wound closure, postoperative local anesthesia with xylocaine 20 mg was administrated over the incision.…”

“…The metal tube was advanced carefully from the premandibular space, through the pretracheal space, and into the submanubrial space. The mediastinal incision was carefully performed according to a previously reported procedure [11]- [13]. Briefly, the blunt tip of the metal tube was used to make a linear incision over the upper anterior mediastinal pleura by blunt dilation.…”

“…However, there have been no large, randomized, controlled trials of NOTES in thoracic surgery. We previously reported the use of a transoral technique to perform thoracoscopy, pericardial window creation, and surgical lung biopsy without complications in a survival canine model [11]- [13]. To further evaluate the potential benefits of transoral thoracoscopy, we aimed to compare the surgical outcome of minor thoracic intervention using the recently developed transoral method compared with the standard transthoracic thoracoscopy in a randomized study.…”