Single-dose antimicrobial prophylaxis in transoral surgical lung biopsy: a preliminary experience
Single-dose antimicrobial prophylaxis in transoral surgical lung biopsy: a preliminary experience
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DOI：
10.1007/s00464-011-1819-6
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发表时间：
2011-12-01
影响因子：
3.1
通讯作者：
Ko, Po-Jen
中科院分区：
文献类型：
--
作者：
Liu, Yun-Hen;Yen-Chu;Ko, Po-Jen
经气管入路至胸腔的可行性已得到证实，但经气管入路的外科肺活检仍是一个挑战。对10只麻醉犬单次静脉注射头孢唑啉(20 mg/kg)后，行经口胸腔镜检查和外科肺活检，评价单次静脉注射抗生素行经口肺活检的可行性和效果。前庭切开12 mm，在内窥镜引导下经气管和胸骨下间隙置入自制金属管入胸腔。胸部探查后，使用电子外科陷阱，通过金属管插入柔性支气管镜，进行外科肺活检。肺切除缘用自制内环固定。术后第14天处死动物，进行大体和组织学检查。10只狗中有9只成功地进行了胸腔和肺活检(右肺3个肺叶，左肺2个肺叶)。无死亡病例，无术中并发症。经口腔胸腔镜术和手术肺活检的平均时间为133.5分钟。尸检显示完全愈合，切除边缘有纤维化和中度粘连。没有观察到纵隔炎或胸腔内感染的证据。这项研究显示了经口胸腔镜检查和外科手术肺活检的可行性。此外，在经口外科肺活检中，头孢唑啉单剂预防被发现在预防潜在感染方面有效。
The feasibility of the transtracheal approach to the thoracic cavity has been demonstrated, but surgical lung biopsy via the tracheal approach still remains a challenge. This study aimed to evaluate the feasibility and outcome of transoral surgical lung biopsy under a single preoperative dose of parenteral antibiotics.Transoral thoracoscopy and surgical lung biopsy were performed for 10 anesthetized dogs after a single intravenous injection of cefazoline (20 mg/kg). A 12-mm transoral incision was created on the vestibulum, and a homemade metallic tube was advanced into the thoracic cavity via the pretracheal and substernal space under endoscopic guidance. After thoracic exploration, surgical lung biopsy was performed using an electrosurgical snare with a flexible bronchoscope inserted through the metallic tube. The resection margin of the lung was secured with a homemade endoloop. The animals were killed by day 14 after the surgery for gross and histologic evaluations.The thoracic cavity was evaluated and lung biopsy was performed successfully (for 3 lobes in the right lung and 2 lobes in the left lung) in 9 of the 10 dogs. Neither mortality nor intraoperative complications were observed. The average time for the transoral thoracoscopy and surgical lung biopsy was 133.5 min. Postmortem examination showed complete healing, with fibrosis and moderate adhesion over the resection margin. No evidence of either mediastinitis or intrathoracic infection was observed.This study showed the feasibility of transoral thoracoscopy and surgical lung biospy in dogs. Moreover, single-dose prophylaxis with cefazoline in transoral surgical lung biopsy was found to be effective in preventing potential infection.