title: Single-dose antimicrobial prophylaxis in transoral surgical lung biopsy: a preliminary experience.
abstract: BACKGROUND
  The feasibility of the transtracheal approach to the thoracic cavity has been demonstrated, but surgical lung biopsy via the tracheal approach still remains a challenge. This study aimed to evaluate the feasibility and outcome of transoral surgical lung biopsy under a single preoperative dose of parenteral antibiotics.
  
  
  METHODS
  Transoral thoracoscopy and surgical lung biopsy were performed for 10 anesthetized dogs after a single intravenous injection of cefazoline (20 mg/kg). A 12-mm transoral incision was created on the vestibulum, and a homemade metallic tube was advanced into the thoracic cavity via the pretracheal and substernal space under endoscopic guidance. After thoracic exploration, surgical lung biopsy was performed using an electrosurgical snare with a flexible bronchoscope inserted through the metallic tube. The resection margin of the lung was secured with a homemade endoloop. The animals were killed by day 14 after the surgery for gross and histologic evaluations.
  
  
  RESULTS
  The thoracic cavity was evaluated and lung biopsy was performed successfully (for 3 lobes in the right lung and 2 lobes in the left lung) in 9 of the 10 dogs. Neither mortality nor intraoperative complications were observed. The average time for the transoral thoracoscopy and surgical lung biopsy was 133.5 min. Postmortem examination showed complete healing, with fibrosis and moderate adhesion over the resection margin. No evidence of either mediastinitis or intrathoracic infection was observed.
  
  
  CONCLUSIONS
  This study showed the feasibility of transoral thoracoscopy and surgical lung biospy in dogs. Moreover, single-dose prophylaxis with cefazoline in transoral surgical lung biopsy was found to be effective in preventing potential infection.
authors.affiliation: Laboratory Animal Center, Department of Surgery, Chang Gung Memorial Hospital at Linko, Chang Gung University, 5, Fushing Street, Gueishan Shiang, Taoyuan, Taiwan 333, ROC. zebraairmail@gmail.com
authors.forename: Yun-Hen
authors.initials: YH
authors.lastname: Liu
authors.lastname: Yen-Chu
authors.forename: Yi-Cheng
authors.initials: YC
authors.lastname: Wu
authors.forename: Chi-Ju
authors.initials: CJ
authors.lastname: Yeh
authors.forename: Chien-Ying
authors.initials: CY
authors.lastname: Liu
authors.forename: Ming-Ju
authors.initials: MJ
authors.lastname: Hsieh
authors.forename: Tzu-Ping
authors.initials: TP
authors.lastname: Chen
authors.forename: Hsu-Chia
authors.initials: HC
authors.lastname: Yuan
authors.forename: Po-Jen
authors.initials: PJ
authors.lastname: Ko
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001707:Biopsy, Needle / Q000295:instrumentation / Q000379:methods; D001831:Body Temperature; D002437:Cefazolin / Q000008:administration & dosage*; D004285:Dogs; D004334:Drug Administration Schedule; D004867:Equipment Design; D005240:Feasibility Studies; D007958:Leukocyte Count; D008168:Lung / Q000473:pathology*; D013906:Thoracoscopy / Q000295:instrumentation / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin