Toracoscopia aplicada à ressecção de fragmento pulmonar com o auxílio de sutura mecânica em eqüinos Thoracoscopy for resection of lung fragment in horses with the aid of mechanical suturing

Este trabalho visou à ressecção de fragmento dorsocaudal do lobo pulmonar caudal esquerdo com o auxílio de sutura mecânica por via toracoscópica. Foram utilizados 10 eqüinos clinicamente sadios, os quais foram sedados e mantidos em estação. O procedimento foi realizado no hemitórax esquerdo, por três acessos previamente programados: o primeiro acesso foi no 12º espaço intercostal (EIC), o segundo no 14º, 15º ou 16º EIC e o terceiro no 14º ou 15º EIC, conforme a necessidade de posicionamento dos instrumentos. Em todos os animais foi possível controlar o pneumotórax, sendo observada evolução clínica satisfatória durante o período pós-operatório, exceto em um animal. Os resultados obtidos indicam que, por meio da videotoracoscopia, pode-se realizar ressecção pulmonar parcial com uso de sutura mecânica em eqüinos e seu emprego na rotina hospitalar poderá contribuir para melhor compreensão e controle de enfermidades sediadas na cavidade torácica.<br>In this study, a dorsocaudal portion resection of the left caudal lung lobe was performed using an endoscopic stapler by thoracoscopic procedure. Ten healthy horses, eight males and two females were evaluated by clinical examination and submitted to the surgical procedure. The animals were sedated and maintained in standing position. The procedure was done in the left hemitorax using three access previously studied: the first portal was done at the 12th intercostal space (IS); the second one at the 14th, 15th, or 16th IS; and the third one at the 14th or 15th IS, in accordance with the necessity of positioning the instruments. The employed surgical technique seemed to be adequate in all animals, since it helped controlling the existing pneumothorax; furthermore, clinical recovery during the postoperative period was satisfactory, except for one animal. These results suggest that thoracoscopic may successfully be employed for partial lung resection in horses, using endoscopic staplers, and its practical use may contribute to the knowledge and resolution of thoracic diseases

Video-assisted thoracoscopic surgery lobectomy at 20 years: A consensus statement

OBJECTIVE: Video-assisted thoracoscopic surgery (VATS) lobectomy has been gradually accepted as an alternative surgical approach to open thoracotomy for selected patients with non-small-cell lung cancer (NSCLC) over the past 20 years. The aim of this project was to standardize the perioperative management of VATS lobectomy patients through expert consensus and to provide insightful guidance to clinical practice. METHODS: A panel of 55 experts on VATS lobectomy was identified by the Scientific Secretariat and the International Scientific Committee of the '20th Anniversary of VATS Lobectomy Conference-The Consensus Meeting'. The Delphi methodology consisting of two rounds of voting was implemented to facilitate the development of consensus. Results from the second-round voting formed the basis of the current Consensus Statement. Consensus was defined a priori as more than 50% agreement among the panel of experts. Clinical practice was deemed 'recommended' if 50-74% of the experts reached agreement and 'highly recommended' if 75% or more of the experts reached agreement. RESULTS: Fifty VATS lobectomy experts (91%) from 16 countries completed both rounds of standardized questionnaires. No statistically significant differences in the responses between the two rounds of questioning were identified. Consensus was reached on 21 controversial points, outlining the current accepted definition of VATS lobectomy, its indications and contraindications, perioperative clinical management and recommendations for training and future research directions. CONCLUSION: The present Consensus Statement represents a collective agreement among 50 international experts to establish a standardized practice of VATS lobectomy for the thoracic surgical community after 20 years of clinical experience. The Author 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe