Thoracoscopic lung lobectomy for benign and malignant disease

A thoracoscopic approach for lung lobectomy is a standard of care procedure for management of many pulmonary lesions in humans that require surgical excision. This procedure has now been described as a thoracoscopic^1-4 as well as a thoracoscopic-assisted^5,6 procedure in both experimental and clinical canine cases and is being used with greater frequency in small animal practice.

Lung lobectomy can be indicated for either benign or malignant disease and we have used both fully thoracoscopic and thoracoscopic-assisted approaches for both these indications. In the authors practice the principle indications for treatment of malignant disease has been primary lung lobe tumors as well as metastatic disease. The most common benign indications have been for treatment of grass-awn related pyothorax or pneumothorax and the treatment of chronic pneumonia complicated by lung lobe consolidation. A thoracoscopic-assisted technique is technically easier because it does not necessarily require advanced anesthetic techniques such as one-lung ventilation (OLV). The assisted technique can be used for benign disease or for resection of thoracic masses that are modestly sized and located distant from the pulmonary hilus.^5,6 Fully thoracoscopic approaches are more complex and usually require OLV as well as endoscopic stapling devices such as the EndoGIA but allow a wider spectrum of lesion sizes and locations to be resected. Contraindications to thoracoscopic lung lobectomy whether it be for benign or malignant disease include the presence of large pulmonary masses, inexperience with the technique and the presence of comorbidities that may make anesthesia and especially OLV poorly tolerated by the patient. [...]