Feasibility of lung lobectomy through a transdiaphragmatic approach in dogs

Abstract

Background: Different pulmonary pathologies may require a partial or total lung lobectomy as treatment. This study compared two techniques for performing a caudal pulmonary lobectomy: a traditional lateral thoracotomy (LT) and a novel transdiaphragmatic (TD) approach. Methods: TD and LT approaches were performed on each of 18 canine cadavers. The operator and order of intervention were randomised at the beginning of the study. To compare both techniques, surgical time, percentage of area of lobe removed, incision length and iatrogenic damage were recorded. Results: The mean length of surgery for the TD approach (1155 ± 232.8 seconds) was non-inferior to the LT approach (1126.8 ± 180.6 seconds) (p = 0.6131). The mean percentage of the area of caudal lobe that was successfully removed during the TD approach was 25.83 ± 8.95% (range 10.55‒40.72%) of the lobe surface, while 100% of the caudal lobe was removed during the LT approach. There was no statistical difference in iatrogenic damage between the procedures. Limitations: This is a non-inferiority ex vivo study carried out by three different surgeons, and no leak test was performed after lobectomies. Conclusion: Partial caudal lung lobectomy can be performed in dogs by the TD approach without greater iatrogenic damage or longer surgical duration than the traditional LT approach.