1887

Surgery of the lung

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Abstract

The lungs are divided into distinct lobes by fissures, allowing them to accommodate the movements of the thoracic wall and diaphragm. This chapter covers anatomy and physiology, diagnostic approach, postoperative considerations, lung trauma, pulmonary abscess, pneumonia and bronchiectasis, lung lobe torsion, spontaneous pneumothorax and lung neoplasia. : Partial or complete lung lobectomy.

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Figures

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14.1 (a) An endoscopic stapler is seen in place across a section of lung lobe. (b) After discharge of the staple cartridge the triple rows of staples can be seen on either side of the resection site.
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14.2 Port placement for VATS lung lobectomy of the caudal lung lobes. VATS = video-assisted thoracoscopic surgery.
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14.3 Port placement for VATS lung lobectomy of the cranial lung lobes. VATS = video-assisted thoracoscopic surgery.
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14.5 (a) Radiograph showing severe subcutaneous emphysema and multiple rib fractures in a 2-year-old Miniature Poodle that had sustained thoracic bite wounds. (b) At surgery, severe damage to ribs and thoracic wall musculature can be appreciated. The dog also sustained a traumatic impalement of a lung lobe caused by the sharp ends of one of the fractured ribs.
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14.6 (a) Rib fractures (b) repaired using Kirschner wires.
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14.7 (a) Lateral and (b)ventrodorsal radiographs of an Afghan Hound with a right middle lung lobe torsion. Note the pleural effusion and prominent air bronchogram secondary to congestion of the affected lobe on the lateral view, and the appearance of the right middle lobe on the ventrodorsal view.
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14.8 Pulmonary bleb in a 7-year-old Old English Sheepdog.
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14.9 Ruptured bulla excised by using a thoracoabdominal stapler to perform partial lung lobectomy.
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14.10 Lateral thoracic radiograph of a 14-year-old Domestic Longhaired cat with a primary lung tumour.
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14.11 Hypertrophic osteopathy of the radius and ulna in a 10-year-old mixed-breed dog with a primary lung tumour.
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14.12 Complete lung lobectomy (right middle lung lobe) using thoracoabdominal stapling equipment.
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Partial lung lobectomy for removal of an apical lesion (dark circle). A haemostatic/pneumostatic overlapping continuous suture pattern is placed 5 mm proximal to the forceps. The lobe is incised along the dotted line and oversewn using a simple continuous pattern. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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Preplacement of interrupted horizontal mattress sutures in the bronchus. The mattress sutures are then tied and the end of the bronchus is oversewn using a simple continuous pattern. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.

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