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Thoracoscopic Lung Biopsies in Heaves-Affected Horses Using a Bipolar Tissue Sealing System

Authors

  • Fabien Relave DVM, Diplomate ACVS,

    1. Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
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  • Florent David DVM, M Sc, Diplomate ACVS & ECVS,

    1. Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
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  • Mathilde Leclère DVM, Diplomate ACVIM,

    1. Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
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  • Kate Alexander DVM, M Sc, Diplomate ACVR,

    1. Département de Radiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
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  • Pierre Hélie DVM, Diplomate ACVP,

    1. Département de Pathologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
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  • Michael Meulyzer DVM, Diplomate ACVS,

    1. Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
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  • Jean Pierre Lavoie DVM, Diplomate ACVIM,

    1. Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
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  • Marcel Marcoux DVM, M Sc

    1. Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
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Corresponding Author
Fabien Relave, DVM, Diplomate ACVS, Clinique vétérinaire de Conques, Château de Conques, 33420 Saint Aubin de Branne, France
E-mail: frelave@yahoo.fr

Abstract

Objective: To validate the use of the LigaSure™ Vessel Sealing System (LVSS) to perform thoracoscopic lung tissue biopsies in heaves-affected horses.

Study design: Prospective clinical study.

Animals: Heaves-affected horses (n=12).

Methods: Lung biopsies (n=34) were collected with the LVSS (2–4 biopsies/horse) in horses with and without clinical signs of heaves. Thoracoscope (13th intercostal space [ICS]) and 2 instruments (between the 12–15th ICS) portals were used. Selected clinical and arterial blood gas variables were monitored. Postoperative pneumothorax was evaluated. Depth of thermal injury to the surrounding tissue and representativeness of the biopsies were determined.

Results: Mean surgical time was 22.9±8.0 minutes. The complication rate was 5.6%, and primarily related to a focal inadequate sealing of the biopsy margin. Five horses in exacerbation required intraoperative intranasal O2. Mean PaO2 was significantly lower in heaves-affected horses with clinical signs compared with those without clinical signs. Postoperative pneumothorax was detected radiographically after 20 of the 34 procedures. One horse with clinical signs of heaves developed a fatal tension pneumothorax 5 days postoperatively despite close radiographic monitoring.

Conclusion: Thoracoscopic lung biopsy using LVSS is a rapid and effective technique to harvest peripheral lung tissues from heaves-affected horses. Although the complication rate was tolerable, tension pneumothorax was a potential life-threatening complication because of incomplete lung sealing.

Clinical Relevance: LVSS can be used with relative safety to perform thoracoscopic lung biopsy, but close postoperative monitoring is necessary to avoid tension pneumothorax.

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