RESUMEN
OBJECTIVE: To describe hepatic vasculobiliary anatomy important to hilar liver lobe resection in the dog. STUDY DESIGN: Experimental study. ANIMALS: Canine cadavers (n=7). METHODS: The vasculobiliary system of 7 fresh canine livers was injected with a polymer. The parenchyma was dissected at the level of the hilus to determine the vascular and biliary supply to each liver lobe, and then macerated with a corrosion preparation. The information gathered was used to describe a surgical approach for hilar liver lobe resection. RESULTS: Each liver lobe had a single hepatic artery and biliary duct. The location of these structures was consistent, although minor variations existed (dorsal versus ventral to the lobar portal vein) in the left lateral lobe and papillary process in 2 specimens. Most liver lobes (34/49) were supplied by 1 lobar portal vein and drained by 1 lobar hepatic vein (39/49). The location of the portal and hepatic veins was consistent among specimens. CONCLUSIONS: The left division is the most mobile of the liver lobes and each lobe can be removed separately or en bloc. Because of the location of the hepatic veins, the central division is best removed as a single unit. The right lateral lobe can be removed individually or together with the caudate process. The papillary process is removed by itself. CLINICAL RELEVANCE: A hilar liver lobectomy technique can provide an alternative approach to conventional procedures for tumors that encroach upon the hilus of the liver.
Asunto(s)
Procedimientos Quirúrgicos del Sistema Biliar/veterinaria , Perros/anatomía & histología , Hígado , Animales , Conductos Biliares Extrahepáticos/anatomía & histología , Conductos Biliares Extrahepáticos/irrigación sanguínea , Conductos Biliares Intrahepáticos/anatomía & histología , Conductos Biliares Intrahepáticos/irrigación sanguínea , Cadáver , Disección/veterinaria , Perros/cirugía , Hepatectomía , Arteria Hepática/anatomía & histología , Venas Hepáticas/anatomía & histología , Hígado/anatomía & histología , Hígado/irrigación sanguínea , Hígado/cirugíaRESUMEN
Reducing reperfusion injury to skin flaps is an effective means to improve the survival of the flap. By enhancing oxygen delivery to the microcirculation within the flap, ischemia-reperfusion injury should be decreased, improving the flap's survival. This study evaluated the effects of a hemoglobin-based oxygen carrier (Oxyglobin) on the development of necrosis and survival of ischemic rat island groin flaps. Sprague-Dawley rats were randomly assigned to one of three treatment groups. A groin flap was elevated on each rat and subjected to 9 h of ischemia. Rats in group I were given an intravenous infusion of 0.9% saline prior to elevation of the skin flap. Rats in group II were given an intravenous infusion of Oxyglobin prior to elevation of the skin flap. Rats in group III were given a low-dose intravenous infusion of Oxyglobin following the 9 h of ischemia, just prior to reperfusion. The flaps were monitored for 7 days postoperatively for necrosis. The percentage of flap necrosis was recorded at the end of 7 days. All rats were euthanized at the completion of the study and the flaps were harvested for histopathological analysis. No significant difference was noted in the survival of the flaps or the degree of necrosis in the rats treated with Oxyglobin compared to the control group. Thus, pre-reperfusion treatment with Oxyglobin did not improve the percentage of flap survival, or the degree of severity of necrosis in rat groin flaps subjected to 9 h of ischemia.
Asunto(s)
Proteínas Portadoras/uso terapéutico , Ingle/patología , Hemoglobinas/uso terapéutico , Oxígeno/uso terapéutico , Daño por Reperfusión/mortalidad , Daño por Reperfusión/prevención & control , Colgajos Quirúrgicos/patología , Animales , Ingle/irrigación sanguínea , Masculino , Necrosis/mortalidad , Necrosis/patología , Necrosis/prevención & control , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley , Daño por Reperfusión/patología , Colgajos Quirúrgicos/irrigación sanguínea , Tasa de Supervivencia , Factores de TiempoRESUMEN
A 2-year-old, intact male Newfoundland was presented for evaluation of a 1- to 2-day history of coughing, retching, and progressive lethargy. Thoracic radiographs demonstrated right-sided pleural effusion and lobar vesicular emphysema. An exploratory thoracotomy revealed midlobar torsion of the right caudal lung lobe. A partial lung lobectomy was performed, and following surgery, the dog recovered without complications. Lung lobe torsions in dogs typically occur at the hilus of the affected lung lobe. This report documents that midlobar lung lobe torsions occur in dogs and should be considered as a differential diagnosis in cases of lobar vesicular emphysema and pleural effusion.