METHODS: 49 client-owned dogs that underwent thoracoscopic cranial mediastinal mass removal.
METHODS: This was a retrospective cohort study (January 1, 2014, to July 31, 2023), and the medical records of 49 client-owned dogs that underwent thoracoscopic cranial mediastinal mass removal were reviewed. The signalment, history, clinicopathologic features, perioperative complications, and long-term outcome were recorded.
RESULTS: Preoperative myasthenia gravis (MG) and megaesophagus (ME) were identified in 17 of 49 (35%) dogs and 11 of 49 (22%) dogs, respectively. The median maximal tumor diameter on CT images was 4.7 cm (range, 2.7 to 8.5 cm). Nonemergent conversion to an open procedure was necessary in 4 of 49 (8%) dogs, and dogs with conversion to an open procedure had a significantly larger median maximal CT tumor diameter than dogs without conversion (P = .03). The most common tumor type was thymoma (37/49 [76%]). The overall median survival time for dogs with thymoma was 1,102 days (95% CI, 482 to upper bound not reached). The median survival time for dogs with thymoma and concurrent presurgical MG was 182 days (95% CI, 14 to upper bound not reached). Presurgical diagnosis of MG (P = .44) or ME (P = .69) was not associated with survival time.
CONCLUSIONS: Thoracoscopic removal of cranial mediastinal masses was associated with low conversion and complication rates. Long-term survival is possible, and thoracoscopic removal should be considered for select cases.
方法:49只接受胸腔镜颅骨纵隔肿块切除术的受助犬。
方法:这是一项回顾性队列研究(2014年1月1日至2023年7月31日),并回顾了49只接受胸腔镜颅骨纵隔肿块切除术的患者的医疗记录.标志,历史,临床病理特征,围手术期并发症,并记录长期结果。
结果:在49只狗中的17只(35%)和49只狗中的11只(22%)中发现了术前重症肌无力(MG)和巨食管(ME)。分别。CT图像上的中位最大肿瘤直径为4.7cm(范围,2.7至8.5厘米)。49只狗中有4只(8%)需要非紧急转换为开放程序,与未转换的狗相比,转换为开放程序的狗的中位最大CT肿瘤直径明显更大(P=0.03)。最常见的肿瘤类型是胸腺瘤(37/49[76%])。患有胸腺瘤的狗的总体中位生存时间为1,102天(95%CI,482至上限未达到)。患有胸腺瘤和并发术前MG的狗的中位生存时间为182天(95%CI,14至上限未达到)。术前诊断为MG(P=0.44)或ME(P=0.69)与生存时间无关。
结论:胸腔镜下切除颅骨纵隔肿块的转化率和并发症发生率较低。长期生存是可能的,选择病例应考虑胸腔镜切除。