Ex vivo evaluation of canine lung biopsy techniques.

Abstract

OBJECTIVE: An ex vivo comparison of thoracoscopic lung biopsy techniques in dogs. STUDY DESIGN: Experimental. SAMPLE POPULATION: Cadaveric canine lung lobes. METHODS: Lungs were inflated to 10 cmH2 O. After collecting biopsies 3 cm from the edge of lung lobes, leak pressures were recorded as inflation pressure was increased to 40 cmH2 O. Pre-tied loop ligature, square knot (SQ), modified 4S Roeder knot (M4SR) with glycomer 631 and polyglactin 910 size 0 and 2-0 were used in addition to EndoGIA 45-2.5 mm (Covidien, Norwalk, CT) and a vessel sealant device (VSDS single and VSDD double seal). Six biopsies were performed with each of these modalities. RESULTS: Median airway pressure at which leakage occurred was 28 (20-34)cmH2 O for EndoGIA 45; 33 (14-40) for VSDD; and 33 (10-40) for VSDS while other groups reached a median pressure of 40 cmH2 O (P < .0001). Leakage occurred at 20 cmH2 O in 1 sample with the EndoGIA and the VSDS, and in 2 with the VSDD while leakage did not occur in any other group (P = .36). Leakage occurred at 30 cmH2 O in 1 specimen each of the 0-polyglactin SQ, 2-0 glycomer 631 M4SR, 2-0 polyglactin M4SR, and 2-0 Surgitie (Covidien, Norwalk, CT); 2 with the VSDS; and 3 with the EndoGIA and the VSDD while leakage did not occur in any other group (P = .26). CONCLUSIONS: All tested techniques seemed safe except the vessel sealant device since it did not consistently seal every biopsy and leaked at pressures <20 cmH2 O.