Parasternal thoracotomy via sternocostal disarticulation: a novel surgical approach to the canine thorax

Abstract

OBJECTIVE To describe the technique and outcomes of a modified paramedian thoracic approach in dogs involving a parasternal thoracotomy via rib disarticulation at the sternocostal joint. ANIMALS 93 client-owned dogs. METHODS Medical records of dogs that underwent parasternal thoracotomy at a private practice between the years 2015 and 2021 were reviewed. Signalment, weight, clinical presentation, surgical details, complications, and short-term outcomes were recorded. Cox proportional hazards regression models were utilized to analyze the impact of covariates on hazard events. Kaplan-Meier curves were employed to evaluate survival functions for select variables. RESULTS Parasternal thoracotomy via sternocostal disarticulation was performed in 93 dogs. Eighty-eight dogs (94.6%) survived the procedure. Eighty-three dogs (89.2%) survived to discharge from the hospital. Age, weight, postoperative time to eating, postoperative ambulation, and surgical or anesthetic duration were not significantly associated with survival to discharge. Thoracostomy tube duration significantly decreased the likelihood for survival to discharge; for each additional hour of thoracostomy tube placement, the odds of survival to discharge diminished by 5.7% (hazard ratio, 0.94; 95% CI, 0.912 to 0.976). CLINICAL RELEVANCE Parasternal thoracotomy via rib disarticulation at the sternocostal joints may be a viable alternative to median sternotomy that does not require specialized equipment for bilateral hemithoracic visualization. Postoperative complications and short-term outcomes are comparable to those reported for the traditional median sternotomy approach. Prolonged thoracostomy tube duration may impact survival to discharge.