Feasibility of laparoscopic liver lobectomy in dogs.

Veterinary surgery : VS Pub Date : 2021-07-01 Epub Date: 2021-02-11 DOI:10.1111/vsu.13566
Aleisha E Michael, J Brad Case, Federico Massari, Michelle A Giuffrida, Philipp D Mayhew, Jose L Carvajal, Penny J Regier, Jeffrey J Runge, Ameet Singh
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引用次数: 3

Abstract

Objective: To determine the feasibility of laparoscopic liver lobectomy (LLL) in dogs by using canine cadavers and to describe the clinical application in dogs with liver disease.

Study design: Ex vivo experiment and descriptive case series.

Sample population: Twelve canine cadavers and six client-owned dogs.

Methods: Cadavers underwent LLL with an endoscopic stapler. The percentage of liver lobe resected was determined by volume. The distance from the staple line to hilus was measured. Medical records of dogs undergoing LLL were reviewed.

Results: In cadavers ≤15 kg, left lateral lobectomy completeness was 87.3% (84.6%-96.6%), and remaining median (interquartile range) hilar length was 1 cm (0.25-1.75). Left medial lobectomy completeness was 72.5% (66.7%-80%), and remaining hilar length was 1.6 cm (0.47-1.75). Central division resection completeness was 68.3% (60%-92.9%), and remaining hilar length was 2.7 cm (0.8-5). Laparoscopic liver lobectomy was not feasible for right division lobes and in cadavers >15 kg. Five dogs with peripheral quadrate or left lateral lobe masses underwent stapled, partial laparoscopic lobectomy (30%-90%). One dog underwent stapled, left lateral lobectomy (90%) after open procedure conversion. Histopathological diagnoses included hepatocellular carcinoma (3), nodular hyperplasia (1), biliary cyst adenoma (1), and fibrosis (1).

Conclusion: Laparoscopic liver lobectomy of the left and central divisions is feasible in cadavers ≤15 kg with an endoscopic stapler. Partial LLL of the left and central divisions is feasible in select dogs with liver disease.

Clinical significance: Laparoscopic liver lobectomy may be a viable alternative to laparotomy in small-to-medium size dogs with peripheral liver masses of the left and central divisions.

犬腹腔镜肝叶切除术的可行性。
目的:探讨犬尸体腹腔镜下肝叶切除术(LLL)的可行性,并探讨其在肝病犬中的临床应用。研究设计:体外实验和描述性病例系列。样本人群:12具犬类尸体和6只客户拥有的狗。方法:采用内窥镜吻合器对尸体进行LLL手术。肝叶切除百分率以体积计。测量从钉线到牙门的距离。回顾了接受LLL治疗犬的医疗记录。结果:在≤15 kg的尸体中,左侧肺叶切除完成率为87.3%(84.6% ~ 96.6%),肺门长度剩余中位数(四分位间距)为1 cm(0.25 ~ 1.75)。左侧内侧肺叶切除完整性为72.5%(66.7% ~ 80%),剩余肺门长度为1.6 cm(0.47 ~ 1.75)。中心分区切除完成率为68.3%(60% ~ 92.9%),剩余门长为2.7 cm(0.8 ~ 5)。腹腔镜下肝叶切除术不适用于右分叶和体重>15公斤的尸体。5只周围方叶或左外侧叶肿块的狗接受了缝合,部分腹腔镜肺叶切除术(30%-90%)。一只狗在开放手术转换后接受了左外侧肺叶缝合切除术(90%)。组织病理学诊断包括肝细胞癌(3例)、结节性增生(1例)、胆道囊肿腺瘤(1例)和纤维化(1例)。结论:内镜下吻合器对体重≤15kg的尸体行左、中分叶腹腔镜肝切除术是可行的。部分左分区和中央分区的LLL是可行的选择狗的肝脏疾病。临床意义:腹腔镜肝叶切除术可能是一个可行的替代剖腹手术对中小型犬周围肝肿块的左和中央分区。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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