Feasibility of Endoscopic Transoral Surgical Lung Biopsy in a Live Canine Model

Liu, Yun-Hen; Chu, Yen; Wu, Yi‐Cheng; Chen, Tzu-Ping; Lu, Ming‐Shian; Lu, Hung-Yi; Yuan, Hsu-Chia; Ko, Po‐Jen

doi:10.1177/1553350611421915

Cited by 3 publications

(5 citation statements)

References 22 publications

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“…We recently published a study demonstrating the successful performance of a minor thoracic procedure via a transoral approach in a canine model [11]–[13]. In line with these findings, our present study further demonstrated the safety and efficacy of the transoral approach in hemodynamic, inflammatory conditions.…”

Section: Discussionsupporting

confidence: 87%

“…However, there have been no large, randomized, controlled trials of NOTES in thoracic surgery. We previously reported the use of a transoral technique to perform thoracoscopy, pericardial window creation, and surgical lung biopsy without complications in a survival canine model [11]–[13]. To further evaluate the potential benefits of transoral thoracoscopy, we aimed to compare the surgical outcome of minor thoracic intervention using the recently developed transoral method compared with the standard transthoracic thoracoscopy in a randomized study.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Hemodynamic and Inflammatory Changes between Transoral and Transthoracic Thoracoscopic Surgery

Chu

Liu²,

Wu³

et al. 2013

PLoS ONE

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BackgroundNatural orifice transluminal endoscopy has been developed for abdominal surgical procedures. The aim of this study was to compare the surgical outcome between a novel transoral approach and a standard transthoracic approach for the thoracic cavity in a canine model.MethodsTwenty-eight dogs were assigned to transoral (n = 14) or standard thoracoscopy (n = 14). Each group underwent thoracic exploration, pre-determined surgical lung biopsy, and pericardial window creation. Blood draws were obtained before surgery and at postoperative days 1, 3, 7, and 14. Operative time, complications, laboratory parameters, hemodynamic parameters, and inflammatory parameters were compared between the two procedures. The animals were monitored for two weeks and necropsy were performed for surgical outcome evaluation.ResultsThe thoracic procedures were successfully performed in all of the dogs, with the exception of one animal in the transoral group. There were no serious acute or delayed complications related to surgery. There was no difference between the two surgical groups for each of the hemodynamic parameters that were evaluated. Regarding the immunological impact of the surgeries, transoral thoracoscopy was associated with significant elevations in interleukin 6 and c-reactive protein levels on postoperative days 1 and 3, respectively, when compared with the standard thoracoscopy. All dogs recovered well, without signs of mediastinitis or thoracic infection. Necropsy revealed absence of infection, no injury to vital organs, and confirmed the success of the novel procedure.ConclusionsThis study suggests that both techniques were comparable with respect to procedure success rate, hemodynamic impact, and inflammatory changes. Furthermore, there was no difference in the incidence of postoperative discomfort between groups.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Comparison of Hemodynamic and Inflammatory Changes between Transoral and Transthoracic Thoracoscopic Surgery

Chu

Liu²,

Wu³

et al. 2013

PLoS ONE

Self Cite

View full text Add to dashboard Cite

show abstract

“…In 2011, our research group showed that identification of the anterior medial aspect of the thoracic cavity is possible with the transoral approach, and creation of a pericardial window and surgical lung biopsy is technically feasible in a canine model [11]- [13]. In this comparative study, 93% of the target lung regions were successfully accessed by the present approach.…”

Section: Discussionmentioning

confidence: 82%

“…The metal tube was advanced carefully from the premandibular space, through the pretracheal space, and into the submanubrial space. The mediastinal incision was carefully performed according to a previously reported procedure [11]- [13]. Briefly, the blunt tip of the metal tube was used to make a linear incision over the upper anterior mediastinal pleura by blunt dilation.…”

Section: Dogs and Surgical Proceduresmentioning

confidence: 99%

“…The resected lung margin was reinforced with a homemade (Ethicon, Somerville, NJ, USA) endoloop ligature to prevent air leakage. The vestibular incision was then closed with a running 3-0 Vicryl suture (Ethicon, San Angelo, TX, USA) as previously described [11]- [13]. Soon after completion of wound closure, postoperative local anesthesia with xylocaine 20 mg was administrated over the incision.…”

Section: Dogs and Surgical Proceduresmentioning

confidence: 99%

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