Thirteen dogs with cardiac tamponade resulting from pericardial effusion were prospectively evaluated to determine feasibility and outcome of thoracoscopic partial pericardiectomy. A lateral thoracoscopic approach allowed adequate exposure to remove a 4- to 5-cm-diameter section of pericardium in all dogs. Complete resolution of cardiac tamponade occurred in all dogs for which there was follow-up (11 dogs). Ten of 13 dogs (76.9%) had neoplastic pericardial effusion. One of these dogs remains alive at 220 days postoperatively and is asymptomatic. The mean survival of the remaining 9 patents with neoplastic effusion was 128 days (range, 14-544 days; median, 38 days). Three of 13 patients (23.1%) had idiopathic pericardial effusion. Two of these dogs remain alive at 585 and 1,250 days postoperatively. One dog with idiopathic pericardial effusion developed cardiomyopathy and was euthanized 18 days after the procedure. Results indicate that the procedure was technically successful in all dogs. No anesthetic complications occurred. Procedural complications included phrenic nerve transection (1 dog), lung laceration (1 dog), and moderate intraoperative bleeding (1 dog). No adverse clinical manifestations of the complications were apparent. We conclude that thoracoscopic partial pericardiectomy is technically feasible and offers several advantages over conventional open thoracic surgical pericardiectomy.

Thirteen dogs with cardiac tamponade resulting from pericardial effusion were prospectively evaluated to determine feasibility and outcome of thoracoscopic partial pericardiectomy. A lateral thoracoscopic approach allowed adequate exposure to remove a 4-to 5-cm-diameter section of pericardium in all dogs. Complete resolution of cardiac tamponade occurred in all dogs for which there was follow-up (11 dogs). Ten of 13 dogs (76.9%) had neoplastic pericardial effusion. One of these dogs remains alive at 220 days postoperatively and is asymptomatic. The mean survival of the remaining 9 patents with neoplastic effusion was 128 days (range, 14-544 days; median, 38 days). Three of 13 patients (23.1%) had idiopathic pericardial effusion. Two of these dogs remain alive at 585 and 1,250 days postoperatively. One dog with idiopathic pericardial effusion developed cardiomyopathy and was euthanized 18 days after the procedure. Results indicate that the procedure was technically successful in all dogs. No anesthetic complications occurred. Procedural complications included phrenic nerve transection (1 dog), lung laceration (l dog), and moderate intraoperative bleeding (1 dog). No adverse clinical manifestations of the complications were apparent. We conclude that thoracoscopic partial pericardiectomy is technically feasible and offers several advantages over conventional open thoracic surgical pericardiectomy. P ericardial effusion can result from many causes, 1 and may result in cardiac tamponade when the intraperi-cardial pressure rises sufficiently to affect cardiac function by compressing the heart and limiting diastolic filling. 2 Consequently, stroke volume, arterial pulse pressure, and venous return are significantly decreased and perfusion of vital tissues is impaired. The animal may die if intraperi-cardial pressure is not decreased. 2 Initial management of cardiac tamponade often includes pericardiocentesis. 3 In almost all cases caused by neoplasia and in 40-50% of the cases caused by idiopathic pericardial effusion, cardiac tamponade recurs following pericardio-centesis. 3 In these cases, a partial or total pericardiectomy performed through a lateral thoracotomy or median ster-notomy is often advocated for treatment. These techniques are expensive and have the potential for substantial post-operative complications. Problems with standard open tho-racic surgical procedures include postoperative pain, hy-poventilation, hypothermia, acid-base disturbances, shock, oliguria, and prolonged anesthesia time. 3,4 The purpose of this study was to investigate a less invasive technique for performing a partial pericardiectomy using thoracoscopy in the dog. Materials and Methods Dogs Thirteen dogs with pericardial effusion were referred to the Veterinary Specialty Hospital of San Diego from 1992 through 1996. Peri-cardial effusion with cardiac tamponade was confirmed with 2-dimensional echocardiography characterized by some degree of right atrial and/or right ventricular collapse. The presence or absence of a cardiac From the V...

The purpose of this retrospective study was to determine the feasibility of using the end-to-end anastomosis (EEA) stapling device transrectally for managing distal colonic disease in clinical veterinary cases. Ten animals met the criteria of having distal colonic or rectal resection and anastomosis with the EEA stapling device. The only complications seen after discharge from the hospital were colonic stricture at the anastomosis site in two animals and transient colitis in two animals. The stapled anastomosis has good success when properly applied, and the incidences of stricture formation, leakage, and other potential complications can be kept to a minimum.

Infarctions of the colon and rectum (incidences approximately 1 and 0.5 per cent, respectively) are caused by compromised collateral circulation to the colon and rectum, usually as a result of arteriosclerotic disease of the superior and inferior mesenteric arterial systems, as well as the hypogastric arteries. Patients who have colorectal ischemia after operations for abdominal aortic aneurysms have diarrhea (sometimes bloody), abdominal pain, and distention. The diagnosis may be established by sigmoidoscopic examination. Treatment includes surgical removal of the compromised bowel and creation of a temporary or permanent end colostomy. Prevention of this complication is aided by preservation of primary and collateral circulation, avoidance of hypotension, and preoperative bowel preparation.