Inside-out anal sacculectomy in small dog breeds and cats.

This report describes a new, simple and rapid surgical technique for the removal of anal sac in small dogs and cats. The anal sacs were simply everted using mosquito hemostatic forceps and excised with the aid of an electrocautery surgical unit. On the evaluation of postoperative complications, only one dog of 28 animals experienced short-term minor complications of mild fecal incontinence and scooting. Thus, we suggest that this new surgical technique is easy, inexpensive and time-saving and some of the complications with previously reported methods used for small dog breeds and cats may be avoided by using this technique.

Thyroid carcinosarcoma masquerading as a paraesophageal abscess in a Cane Corso dog.

A 12-year-old castrated male Cane Corso dog was presented with cervical swelling, lethargy, anorexia, and cough. An extensive neck mass with necrotic cysts was observed, severely adherent to surrounding tissues. Based on diagnostic imaging including ultrasound, computed tomography, and fine-needle aspiration cytology, paraesophageal abscess was tentatively diagnosed. However, after the mass was surgically removed, a diagnosis of thyroid carcinosarcoma composed of neoplastic cell populations with epithelial and mesenchymal origins was made via histopathology and immunohistochemistry. The dog died of a recurrent mass with pulmonary metastasis 105 d after surgery. This report describes a rare type of canine thyroid cancer, thyroid carcinosarcoma, preoperatively masquerading as an abscess and postoperatively confirmed by histopathology. Key clinical message: Thyroid carcinosarcoma, despite its rarity in dogs, should be included in the differential diagnoses of cervical mass especially with an aggressive progression.

Carcinosarcome thyroïdien déguisé en abcès paraoesophagien chez un chien Cane Corso. Un chien Cane Corso mâle castré de 12 ans a été présenté avec de l'enflure cervicale, de la léthargie, de l'anorexie et une toux. Une masse étendue du cou avec des kystes nécrotiques a été observée, adhérente fortement aux tissus environnants. Sur la base de l'imagerie diagnostique comprenant l'échographie, la tomodensitométrie et la cytologie par aspiration à l'aiguille fine, un abcès paraoesophagien a été provisoirement diagnostiqué. Cependant, après l'ablation chirurgicale de la masse, un diagnostic de carcinosarcome thyroïdien composé de populations de cellules néoplasiques d'origine épithéliale et mésenchymateuse a été posé par histopathologie et immunohistochimie. Le chien est décédé d'une masse récurrente avec métastase pulmonaire 105 jours après la chirurgie. Ce rapport décrit un type rare de cancer de la thyroïde canine, le carcinosarcome thyroïdien, se faisant passer pour un abcès en préopératoire et confirmé en postopératoire par histopathologie.Message clinique clé:Le carcinosarcome thyroïdien, malgré sa rareté chez le chien, doit être inclus dans les diagnostics différentiels de masse cervicale surtout à évolution agressive.(Traduit par Dr Serge Messier).

Granulomatous Inflammation and Pericarditis Induced by Silk Granuloma Related to Previous Surgical Ligation of Patent Ductus Arteriosus in a Dog.

Surgical ligation of a patent ductus arteriosus is regarded as a standard treatment approach with a low complication rate if performed by experienced surgeons, and it has been performed successfully for decades in dogs. However, there are no reports describing the clinical symptoms related to granulomatous inflammation after the surgical ligation of the patent ductus arteriosus. This report describes the clinical symptoms caused by granulomatous inflammation and subacute pericarditis in a dog that had undergone the surgical closure of a patent ductus arteriosus 2 years previously. Exploratory thoracotomy was performed for subtotal pericardiectomy, and a biopsy was performed to obtain specimens for histopathological examination and culture tests. The clinical symptoms were relieved after surgery. The persistent leukocytosis improved with steroid administration. This case illustrates that the granulomatous inflammatory response associated with silk suture granuloma is a rare postoperative complication of ductal ligation. In such cases, pericardiectomy can help relieve the clinical symptoms.

Case report: Three-dimensionally printed patient-specific acetabular cage for revision surgery of aseptic loosening in a dog with micro total hip replacement.

A 2-year-old castrated male Pomeranian dog was presented for regular follow-up after micro total hip replacement (mTHR) 16 months prior to presentation. Clinically, the dog did not show any noticeable lameness of the left hindlimb, except for external rotation during walking. However, radiographic findings, namely rotation and medialization of the acetabular cup with a periprosthetic lucent line and bone formation medial to the acetabulum, were interpreted as aseptic loosening of the acetabular component. Because the dog was incompatible with the conventional THR revision method owing to severe bone defects in the acetabulum, a patient-specific titanium acetabular cage prosthesis with biflanges and four cranial and one caudal screw hole was designed for revision surgery. A custom-made acetabular cage was prepared, and it had a 12-mm polyethylene cup fixed with polymethylmethacrylate bone cement and positioned in the acetabulum. After the custom-made acetabular cage was anchored to the pelvic bone with the five cortical screws, reduction of the prostheses was achieved smoothly. The dog showed almost normal limb function without external rotation of the left hindlimb 2 weeks postoperatively. Bone remodeling and stable implant position were noted on radiographic images 3 years after revision surgery, with no evidence of loosening. Based on the clinical outcomes, the use of a custom-made acetabular prosthesis can be an effective treatment option for revision arthroplasty in acetabula with severe bone loss and structural changes in small-breed dogs.

Case report: Primary chronic calcaneal bursitis treated with subtotal bursectomy in a cat.

A 6-year-old, female spayed Bengal cat with a bodyweight of 6.4 kg was presented with swelling of the bilateral calcaneal region and weight-bearing hindlimb lameness with a 4-month history of unsuccessful conservative therapy. On orthopedic examination, a cyst-like mass around the calcaneal tendon was palpated. Palpating the mass and flexing the tarsal joint triggered pain. Through ultrasonography and magnetic resonance imaging, an inflamed or fluid-accumulated lesion was suspected around the calcaneal tendon, but there was no evidence of calcaneal tendonitis. Swollen calcaneal bursae were removed surgically. Histopathologic examination revealed fibrosis and an edematous feature. The cat was diagnosed with bilateral chronic primary calcaneal bursitis based on history, clinical signs, and diagnostic results. Hence, subtotal bursectomy was performed. At 4 weeks postoperatively, the cat had no pain around the tarsal joints and was ambulating normally. Radiographic and ultrasonographic exams revealed no recurrence of swelling or inflammation in the calcaneal region. Thirteen-month follow-up confirmed acceptable function and no relapse of clinical signs. The inflammation of calcaneal bursa alone can be the primary cause of hindlimb lameness in cats. A cat with hindlimb lameness and swelling on the calcaneal region should be assessed with the possibility of primary calcaneal bursitis. Subtotal calcaneal bursectomy can be considered as an effective treatment for primary chronic bursitis.

Laparoscopic colopexy for recurrent rectal prolapse in a Maltese dog.

A 2.5-kg castrated male Maltese dog, suspected to be older than 10 y, was presented with a prolapsed mass at the anus. This had occurred on 2 previous occasions within the last 4 mo and had been managed with manual reduction and purse-string sutures. The rectal prolapse had viable tissue and was reducible but resulted in straining and fecal accumulation. Colopexy (with intracorporeal sutures) was performed laparoscopically using 3 ports; the distal colon was retracted cranially and attached to the abdominal wall with 3 simple interrupted sutures in a single row. The dog recovered uneventfully, had good appetite and normal activity, did not strain, and defecated without issues. There were no wound-healing complications and at 12-month post-operative examination, the patient was in good condition without clinical signs. Based on this case report, laparoscopic colopexy is clinically practical for management of rectal prolapse in small-breed dogs.

Colopexie laparoscopique pour prolapsus rectal récurrent chez un chien maltais. Un chien maltais mâle castré de 2,5 kg, suspecté d'avoir plus de 10 ans, a été présenté avec une masse faisant prolapsus à l'anus. Cela s'était produit à deux reprises au cours des quatre derniers mois et avait été géré avec une réduction manuelle et des sutures en bourse. Le prolapsus rectal avait des tissus viables et était réductible mais a entraîné des efforts et une accumulation fécale. La colopexie (avec sutures intracorporelles) a été réalisée par laparoscopie à l'aide de trois ouvertures; le côlon distal a été rétracté crânialement et attaché à la paroi abdominale avec trois sutures interrompues simples en une seule rangée. Le chien s'est rétabli sans incident, avait un bon appétit et une activité normale, ne s'est pas fatigué et a déféqué sans problème. Il n'y avait pas de complications de cicatrisation et lors de l'examen postopératoire de 12 mois, le patient était en bon état sans signes cliniques. Sur la base de ce rapport de cas, la colopexie laparoscopique est cliniquement pratique pour la gestion du prolapsus rectal chez les chiens de petite race.(Traduit par Dr Serge Messier).

Retroperitoneal Metastatic Apocrine Gland Ductal Adenocarcinoma in a Beagle Dog.

Tumors of sweat glands usually originate from apocrine glands and can develop throughout the body but are rare in dogs. This report describes the retroperitoneal metastasis of primary cutaneous apocrine adenocarcinoma. An 8-year-old, spayed female beagle dog, weighing 11.7 kg, presented with a history of anorexia, hypodynamia, and weight loss. Clinical examination, radiography, ultrasonography, and computed tomography revealed a skin mass on the dorsum of the right metatarsal region, an enlarged ipsilateral popliteal lymph node, and a retroperitoneal mass. Fine-needle aspiration cytology of the popliteal lymph node suggested metastasis of an apocrine sweat gland tumor. Surgical excision of the skin mass, popliteal lymph node, and retroperitoneal mass was performed. The retroperitoneal mass was diagnosed as a metastasis of primary cutaneous apocrine adenocarcinoma. Immunohistochemistry revealed that the tumor cells were positive for cytokeratin 7 but negative for cytokeratin 20 and S100 proteins. There were no postoperative complications, except for temporary hindlimb edema, including local recurrence or metastasis, in the 6-month postoperative follow-up period. This case illustrates that although malignant apocrine gland tumors are rare in dogs, a wide resection of primary cutaneous apocrine gland adenocarcinomas is recommended because of the risk of local invasion or distant metastasis.

Leiomyosarcoma of urinary bladder in a Shih Tzu dog.

A 10-year-old intact male Shih Tzu dog presented with hematuria. Double-contrast cystography revealed a polypoid filling defect at the apex of the urinary bladder. Ultrasonography revealed a heterogeneously hypoechoic intramural mass with minimal vascular flow beneath the submucosal layer. After partial cystectomy, a well-demarcated bladder leiomyosarcoma was diagnosed on histopathology. The patient was alive and well without any clinical signs, recurrence, or metastasis at the 29-month follow-up after the surgical removal of the bladder mass. Leiomyosarcoma should be considered as a differential diagnosis if mass-like lesions are observed in the urinary bladder, although this type of malignancy is rare in canines. Histopathological confirmation is important for predicting prognosis and determining further medical plans.

Successful mitral repair in dogs by mitral annuloplasty using Hegar dilator: two case reports.

Mitral regurgitation (MR) is the most common heart disease in small-breed dogs. Mitral repair, which comprise artificial chorda tendineae implantation and mitral annuloplasty, has become the mainstay of treatment in the veterinary field. We report on two small dogs who underwent mitral repair surgery for MR. A Hegar dilator was used during mitral annuloplasty for accurate and reproducible surgery. In both cases, mitral regurgitant flow almost disappeared after surgery, and clinical signs improved. The treatment regimen was terminated 3 months after the surgery. We concluded that using a Hegar dilator may facilitate mitral valve repair surgery.

Ischiocavernosus Muscle Release for Urethral Obstruction Treatment after Pelvic Symphyseal Distraction Osteotomy in a Cat with Pelvic Stenosis.

Symphyseal distraction osteotomy (SDO) with a polymethyl methacrylate (PMMA) spacer is an effective surgical treatment for cats with pelvic stenosis. This study reports the successful treatment of urethral obstruction due to ischiocavernosus muscle (IM) tension after SDO with a PMMA spacer. A 2-year-old castrated male Korean domestic shorthair feline had megacolon and pelvic canal stenosis. The ratio of the maximal diameter of the colon to the L5 length and the pelvic canal diameter ratio were 1.6 and 0.45, respectively. Pelvic SDO was performed with a PMMA spacer, leading to pelvic canal enlargement (pelvic canal diameter ratio: 0.73). Two days after surgery, dysuria was identified immediately after removing the preoperatively placed urinary catheter. Complete blood counts and serum biochemical profiles were within the reference intervals, and a positive contrast retrograde urethrogram confirmed urethral obstruction at the level of the membranous-pelvic urethra region. Increased tension of the IM leading to a narrowed urethra was suspected as the cause of urethral obstruction. After IM release at the level of origin on the ischium, the patient had an uneventful recovery with spontaneous urination. Muscle release resulted in excellent functional restoration, with no intraoperative or postoperative complications reported during the 12-month long-term follow-up. Therefore, SDO with IM release could be a feasible therapeutic option for severe pelvic stenosis without complications, such as urethral obstruction, in cats.

Subsequent meniscal tears following tibial tuberosity advancement and tibial plateau leveling osteotomy in dogs with cranial cruciate ligament deficiency: An in vivo experimental study.

OBJECTIVE: To evaluate the short- and mid-term effects of tibial tuberosity advancement (TTA) and tibial plateau leveling osteotomy (TPLO) on subsequent meniscal tears. STUDY DESIGN: Experimental in vivo study. ANIMALS: Purpose-bred beagle dogs (n = 15). METHODS: For each dog, the cranial cruciate ligaments were transected; one limb underwent TTA and the other limb underwent TPLO. Orthopedic and radiographic examinations were performed preoperatively and at 12 and 32 weeks postoperatively. Gross evaluation of the stifle joint was performed after euthanasia at 12 (n = 10) and 32 (n = 5) weeks. RESULTS: Lameness scores were not different between TTA and TPLO limbs at any time point. Radiographic osteoarthritis scores of TTA stifles (1.33 ± 0.49) were higher than TPLO stifles (0.67 ± 0.49) (p = .002) at 12 weeks postoperatively, but there was no difference between groups at 32 weeks postoperatively. Subsequent medial meniscal tears occurred in 6/10 TTA stifles, and 0/10 TPLO stifles at 12 weeks postoperatively and in 5/5 TTA stifles, and 1/5 TPLO stifles at 32 weeks postoperatively. Subsequent lateral meniscal tears occurred in 4/5 TTA stifles at 32 weeks postoperatively. Medial meniscal total gross pathology score was higher in TTA than TPLO stifles. TTA stifles had more articular cartilage damage when compared with TPLO stifles at 32 weeks postoperatively. CONCLUSION: In this within-dog experimental comparison, subsequent medial meniscal tears and cartilage injury was more prevalent following TTA when compared to TPLO. CLINICAL SIGNIFICANCE: In an experimental model, TPLO protects the medial meniscus and articular cartilage better than TTA in stifles with complete cranial cruciate ligament deficiency.

Comparison between Novice and Experienced Surgeons Performing Corrective Osteotomy with Patient-Specific Guides in Dogs Based on Resulting Position Accuracy.

Corrective osteotomy has been applied to realign and stabilize the bones of dogs with lameness. However, corrective osteotomy for angular deformities requires substantial surgical experience for planning and performing accurate osteotomy. Three-dimensional printed patient-specific guides (3D-PSGs) were developed to overcome perioperative difficulties. In addition, novices can easily use these guides for performing accurate corrective osteotomy. We compared the postoperative results of corrective osteotomy accuracy when using 3D-PSGs in dogs between novice and experienced surgeons. We included eight dogs who underwent corrective osteotomy: three angular deformities of the radius and ulna, three distal femoral osteotomies, one center of rotational angle-based leveling osteotomy, and one corrective osteotomy with stifle arthrodesis. All processes, including 3D bone modeling, production of PSGs, and rehearsal surgery were carried out with computer-aided design software and a 3D-printed bone model. Pre- and postoperative positions following 3D reconstruction were evaluated by radiographs using the 2D/3D registration technique. All patients showed clinical improvement with satisfactory alignment and position. Postoperative accuracy evaluation revealed no significant difference between novice and experienced surgeons. PSGs are thought to be useful for novice surgeons to accurately perform corrective osteotomy in dogs without complications.

Caval foramen hernia in a dog: Preoperative diagnosis and surgical treatment.

A 13-year-old, 5.6-kg castrated-male Maltese was presented for reverse sneezing. A dome-shaped round mass abutting diaphragm was incidentally found ventral to caudal vena cava, which had the same echogenicity and density as that of the liver during ultrasonography and computed tomography, showing isoattenuation with a contrast study. Vascular distribution was identified throughout the mass. A caval foramen hernia (CFH) was diagnosed tentatively, followed by a herniorrhaphy and splenectomy of the chronically congested spleen. The patient had been doing well for 5-month postoperative but died because of aspiration pneumonia. CFH is an extremely rare condition, requiring surgery due to compression of the vena cava. It should be considered as a differential diagnosis when intrathoracic, mass-like lesions are identified near the diaphragm.

Surgical fenestration combined with omentalization for the treatment of renal cysts in 2 dogs.

Two cases of surgical fenestration combined with omentalization for canine renal cysts using laparotomy and laparoscopy are described. After surgery, the cystic lesions gradually diminished in size, and a complete regression was confirmed in Case 2 by ultrasonography. The dogs maintained good condition without clinical signs of renal compromise for 14 months (Case 1) and 24 months (Case 2). Omentalization is a simple and effective procedure for canine renal cysts that conserves the remaining parenchyma and can be performed by a laparoscopic approach.

Fenestration chirurgicale combinée à une omentalisation pour le traitement de kystes rénaux chez deux chiens. Deux cas de fenestration chirurgicale combinée à une omentalisation pour traiter des kystes rénaux canins utilisant la laparotomie et la laparoscopie sont décrits. Après la chirurgie, les lésions kystiques ont graduellement diminué en grosseur, et une régression complète fut confirmée par échographie dans le Cas 2. Les chiens ont maintenu une bonne condition sans signe clinique de complication rénale pendant 14 mois (Cas 1) et 24 mois (Cas 2). L'omentalisation est une procédure simple et efficace pour les kystes rénaux canins qui conserve le parenchyme restant et peut être réalisée par une approche laparoscopique.(Traduit par Dr Serge Messier).

Clinical efficacy and safety of thread-embedding acupuncture for treatment of the sequelae of Bell's palsy: A protocol for a patient-assessor blinded, randomized, controlled, parallel clinical trial.

BACKGROUND: The sequelae of Bell's palsy cause critical problem in facial appearance, as well as social and psychological problems in the patient's life. The aim of the present study is to establish clinical evidence of thread-embedding acupuncture (TEA) in the treatment of sequelae of Bell's palsy. METHOD/DESIGN: This is a patient-assessor blinded, randomized, sham-controlled trial with two parallel arms. Fifty-six patients aged 19-65 years, who have experienced sequelae of Bell's palsy for >3 months, will be recruited and screened using the eligibility criteria. After screening, they will be randomly allocated to a TEA group or a sham TEA (STEA) group. Both groups will receive TEA or STEA treatment on ten predefined acupoints once a week for 8 weeks. Additionally, both groups will receive the same acupuncture treatment twice a week for 8 weeks as a concurrent treatment. Changes in the Facial Disability Index over 8 weeks will be assessed as the primary outcome. Furthermore, the House-Brackmann Grade, Facial Nerve Grading System 2.0, Sunnybrook Facial Grading System, facial stiffness score, lip mobility score, and treatment satisfaction score will be measured and analyzed as secondary outcomes. All outcomes will be assessed at baseline and at 4 and 8 weeks after screening. DISCUSSION: The results from this trial will help establish clinical evidence regarding the efficacy and safety of TEA in the treatment of patients with sequelae of Bell's palsy. TRIAL REGISTRATION NUMBER: KCT0002557 (Clinical Research Information Service of the Republic of Korea).

A Review of Complementary and Alternative Medicine Therapies on Muscular Atrophy: A Literature Review of In Vivo/In Vitro Studies.

OBJECTIVE: The objective of this review is to evaluate the recent treatment and study trends of complementary and alternative medicine (CAM) treatments on muscular atrophy by reviewing in vivo/in vitro studies. MATERIALS AND METHODS: The searches were conducted via electronic databases including PubMed, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang MED, and five Korean databases. Only in vivo and in vitro studies were included in this study. RESULTS: A total of 44 studies (27 in vivo studies, 8 in vitro studies, and 9 in vivo with in vitro) were included. No serious maternal or fetal complications occurred. There were various animal models induced with muscular atrophy through "hindlimb suspension", "nerve damage", 'alcohol or dexamethasone treatment', "diabetes", "CKD", "stroke", "cancer", "genetic modification", etc. In 28 of 36 articles measuring muscle mass, CAM significantly increased the mass. Additionally, 10 of them showed significant improvement in muscle function. In most in vitro studies, significant increases in both the diameter of myotubes and muscle cell numbers were reported. The mechanisms of action of protein synthesis, degradation, autophagy, and apoptotic markers were also investigated. CONCLUSIONS: These results demonstrate that CAM could prevent muscular atrophy. Further studies about CAM on muscular atrophy are needed.

Presurgical assessment of splenic tumors in dogs: a retrospective study of 57 cases (2012-2017).

The purpose of this study was to evaluate the clinical and imaging characteristics of canine splenic tumors and to establish guidelines for the presurgical assessment of splenic tumors in dogs. Fifty-seven dogs that underwent total splenectomy for the treatment of splenic tumors were evaluated by examining medical records, hematologic results, diagnostic imaging results, and histopathologic results. The maximum lesion size from ultrasonography was significantly different between malignant and benign tumors (p = 0.002). There was a correlation between tumor margination and type of splenic tumors (p = 0.045). Precontrast lesion attenuation on computed tomography was significantly different between splenic malignant and benign tumors (p = 0.001). The mean ± SD precontrast lesion attenuation of malignant tumors was 40.3 ± 5.9 Hounsfield units (HU), and for benign tumors, it was 52.8 ± 6.8 HU. In conclusion, some variables of the imaging examination could be used to distinguish the type of splenic tumor. Based on the study results, using a diagnostic flowchart would be effective in increasing the survival rate of patients with splenic malignant tumors. In addition, fine needle aspiration or magnetic resonance imaging prior to surgical exploration and histopathologic examination may be useful in achieving a more accurate diagnosis.

Evaluation of an arthroscopic stifle lever for stifle joint distraction in toy breed dogs.

Arthroscopy has become an attractive modality in the diagnosis and treatment of joint diseases in toy breed dogs. However, the application of arthroscopy is limited by small joint space. Our objective was to evaluate the efficacy of a stifle lever for joint distraction during stifle arthroscopy in toy breed dogs. Paired stifles (n = 32 each) collected from 16 cadavers of toy breed dogs were randomly assigned to one of two groups: the stifle lever group or the external manipulation group. All stifles underwent arthroscopic cranial cruciate ligament transection, and the visualization of the medial meniscus was evaluated. Medial meniscal release (MMR) was then performed. Following arthroscopic examination, the success rates of MMR and damages of tibial and femoral cartilages were evaluated. Visualization of the medial meniscus was significantly better, and meniscal probing was significantly easier, in the stifle lever group than in the external manipulation group (p = 0.001). There were no significant differences between groups for MMR success or articular cartilage damage. Using the stifle lever on arthroscopic examination improved visualization and probing on the medial meniscus in toy breed dogs. The stifle lever can be used as a good modality in assessing medial meniscal pathology in toy breed dogs.

Validation of Nafamostat Mesilate as an Anticoagulant in Extracorporeal Membrane Oxygenation: A Large-Animal Experiment.

BACKGROUND: Unfractionated heparin is commonly used for anticoagulation in extracorporeal membrane oxygenation (ECMO). Several studies have shown that nafamostat mesilate (NM) has comparable clinical outcomes to unfractionated heparin. This study compared anticoagulation with NM and heparin in a large-animal model. METHODS: Beagle dogs (n=8; weight, 6.5-9 kg) were placed on venovenous ECMO. Blood samples were taken every hour and the following parameters were compared: hemoglobin level, activated partial thromboplastin time (aPTT), thromboelastography (TEG) data, platelet function, and inflammatory cytokine levels. RESULTS: In both groups, the aPTT was longer than the baseline value. Although the aPTT in the NM group was shorter than in the heparin group, the TEG parameters were similar between the 2 groups. Hemoglobin levels decreased in both groups, but the decrease was less with NM than with heparin (p=0.049). Interleukin (IL)-1ß levels significantly decreased in the NM group (p=0.01), but there was no difference in the levels of tumor necrosis factor alpha or IL-10 between the 2 groups. CONCLUSION: NM showed a similar anticoagulant effect to that of unfractionated heparin, with fewer bleeding complications. NM also had anti-inflammatory properties during ECMO. Based on this preclinical study, NM may be a good alternative candidate for anticoagulation in ECMO.

Comparison of the effects of isoflurane versus propofol-remifentanil anesthesia on oxygen delivery during thoracoscopic lung lobectomy with one-lung ventilation in dogs.

This study compared effects of isoflurane inhalation (ISO) and propofol-remifentanil combined total intravenous anesthesia (TIVA) on oxygenation during thoracoscopic lung lobectomy with 30-min one-lung ventilation (1LV). Thoracoscopic right middle lung lobectomy was performed in ten dogs divided into ISO and TIVA groups, and cardiopulmonary parameters were measured with blood gas analysis. Throughout the study, isoflurane was inhaled up to 1.5%, and the infusion rates of propofol and remifentanil were 0.2 to 0.4 mg/kg/min and 6 to 11 µg/kg/h, respectively. Cardiac index was not affected in the ISO group, but it increased during 1LV in the TIVA group. There were significant alterations in arterial oxygen pressure, arterial oxygen saturation, oxygen content, and shunt fraction associated with 1LV in each group. However, oxygen delivery did not decrease significantly due to open chest condition, 1LV, or surgical maneuver in either group, rather it increased during 1LV in the TIVA group. All parameters showed no significant difference between groups. Pulmonary vascular resistant index was unaffected in both groups, and there was no difference between groups except in re-ventilation phase. Accordingly, the effect of both anesthetic regimens on oxygenation was not different between groups and can be used with short-term 1LV for thoracoscopic lung lobectomy in dogs.