Evaluation of a thoracoscopic technique using ligating loops to obtain large lung biopsies in standing healthy and heaves-affected horses.

The research article presents a study focused on testing the use of pre-tied ligating loops in large lung biopsies conducted thoracoscopically on healthy and heaves-affected horses. The study finds the technique to be minimally invasive, fairly efficient, and relatively cheap, but with a 31% complication rate.

Methods

• The study involved a group of normal horses (n=5) and heaves-affected horses (n=6).
• Lung biopsies were performed on the subjects thoracoscopically, using pre-tied ligating loops to collect samples from each hemithorax.
• Among the heaves-affected horses, the initial lung biopsies were carried out when they were in remission (Ha), and a second biopsy was taken when the condition was in exacerbation (Hs).
• The impact of surgical biopsy was determined through clinical variables and measurements of partial pressures of oxygen (PaO2) and carbon dioxide (PaCO2).
• Following the procedures, serial thoracic radiographic examinations were conducted to monitor postoperative pneumothorax.

Results

• All the horses well tolerated thoracoscopic lung biopsy that involved 29 biopsies on 22 procedures.
• The complication rate stood at 31%, which consisted of 8 cases of ligature slippage and 1 case of pulmonary hemorrhage.
• During surgery, six horses exhibited severe hypoxemia or labored breathing and had to be given intranasal oxygen.
• In cases where oxygen was not supplemented, a significant decrease in PaO2) was observed during surgery in horses.
• Following the procedure, postoperative pneumothorax, detected in 21 out of 22 procedures, resolved within three weeks.

Conclusions

• Although the study identified a 31% complication rate, thoracoscopic lung biopsy with pre-tied ligating loops proved to be minimally invasive, fairly efficient, and relatively inexpensive.
• The research also shows that heaves-affected horses, even during exacerbation, can tolerate this surgical procedure well. However, there is a need for correction with additional ligating loops or the application of more sophisticated instruments in cases where complications arise.
• A proposal from the study concludes that a thoracoscopically-assisted lung biopsy using pre-tied ligating loop offers a potential solution for horses with both normal and impaired lung function. The availability of alternative tools and access to intranasal oxygen for surgeons is necessary to handle any complications that may occur during the process.