[Changes in cardiorespiratory function after radical esophagectomy by bilateral thoracotomy approach in dogs].
Eighteen dogs (8-21 kg) were anesthetized with pentobarbital sodium, buprenorphine and pancuronium bromide followed by endotracheal intubation in the supine position. Eighteen dogs were divided into two groups. Group 1 (n = 9) underwent thoracic esophagectomy with regional lymph nodes dissection under the right thoracotomy. Group 2 (n = 9) underwent the same manner of Group 1, and then left thoracotomy was additionally performed in the 5th intercostal space to completely dissect the left side mediastinal lymph nodes. During surgical procedure, lactated Ringer's solution (L-R) were continuously administered and Dextran 40 were given according to surgical bleeding. For postoperative fluid therapy, L-R were given at 4 ml/kg/hr under spontaneous breathing. Central venous pressure (CVP), pulmonary arterial pressure (PAP), pulmonary wedge pressure (PWP), mean arterial pressure (AP), heart rate (PR), cardiac output (CO), extravascular lung water (EVLW), blood gas, lung resistance (RL), dynamic lung compliance (CL) and colloid osmotic pressure (COP) were measured at preoperative phase and three days after surgery. Significant differences were found in the PaO2, Qs/Qt, respiratory index (RI) and the dosage of Dextran 40 between Group 1 and Group 2. There are no significant differences in the tracheal ischemic changes between the two groups, but peripheral atelectasis in Group 2 seemed to be severe as compared to that in Group 1. From these results, extended radical esophagectomy by bilateral thoracotomy approach for clinical cases seems to be possible under the exact indication and intensive perioperative care.
Hyodo
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First Department of Surgery, Kurume University School of Medicine, Japan.
D000818:Animals; D004285:Dogs; D016629:Esophagectomy; D006439:Hemodynamics / Q000502:physiology*; D011184:Postoperative Period; D012119:Respiration / Q000502:physiology*; D013908:Thoracotomy / Q000379:methods*