Intercostal Approach for Right Adrenalectomy in Dogs

Authors

  • Natalia Andrade DVM,

    1. Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia
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  • Luis R. Rivas,

    1. Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia
    Current affiliation:
    1. Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX
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  • Milan Milovancev DVM, Diplomate ACVS,

    1. Department Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, Oregon
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  • Mary Ann Radlinsky DVM, MS, Diplomate ACVS,

    1. Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia
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  • Karen Cornell DVM, PhD, Diplomate ACVS,

    1. Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia
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  • Chad Schmiedt DVM, Diplomate ACVS

    Corresponding author
    1. Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia
    • Corresponding Author

      Dr. Chad Schmiedt, DVM, Diplomate ACVS, Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, 501 DW Brooks Dr., Athens, GA 30602.

      E-mail: cws@uga.edu

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  • Presented in part at the University of Georgia Science Day, September 2012, Athens, GA, and presented at the 2013 ACVS Symposium in San Antonio, TX, October 24-26, 2013.

Abstract

Objective

To describe an intercostal (IC) approach to the right adrenal (RA) gland in dogs.

Study Design

Cadaveric study and case series.

Animals

Dogs with right adrenal (RA) tumors (n = 11) and normal canine cadavers (6).

Methods

Cadavers had an IC (n = 3) or paracostal (3) approach to the RA. The relative spatial position of the RA to the incision was evaluated. Medical records (June 2007–December 2012) of dogs that had an IC approach to the RA were reviewed. Perioperative data were recorded and described.

Results

In cadavers, the RA was closer to the cranial aspect of the surgical incision after an IC approach compared with a paracostal approach. The IC approach for right adrenalectomy was successfully performed in 11 dogs (6 adrenocortical carcinomas, 4 pheochromocytomas, and 1 osteosarcoma) with a mean anesthesia duration of 242 minutes and mean surgical of 144 minutes. Dogs had vascular invasion into the phrenicoabdominal vein (n = 11) and caudal vena cava (6). There were no significant intra- or postoperative complications. One dog was euthanatized intraoperatively. Median survival time for all dogs was 786 days.

Conclusions

The IC approach for right adrenalectomy offers superior exposure of the RA compared with a paracostal approach.

Ancillary