Thesis (M.N. (Res.))--University of Sydney, 2003. / Title from title screen (viewed Apr. 28, 2008). Submitted in fulfilment of the requirements for the degree of Master of Nursing (Research) to the School of Clinical Nursing, Faculty of Nursing. Degree awarded 2003; thesis submitted 2002. Includes bibliography. Also available in print form.

Little is known about the recovery of patients after pneumonectomy and the impact of the surgery on the lifestyle of young, employed, ex-smokers and their families. This study was conducted to address this knowledge deficit, and gather information that would help health professionals to be able to assist people facing pneumonectomy. A qualitative study using van Manens methodological approach to interpretive phenomenology was chosen, in order to capture a full and rich understanding and meaning of the phenomenon that patients live. The names, age, operation, histological cell type, stage of disease, and disease free status of potential participants were obtained from a Lung Cancer Surgical Database after obtaining ethical approval for the study. Nine participants (three females and six males) met the inclusion criteria and gave informed consent for the study. Data collection comprised of open-ended interviews that were audiotaped, then transcribed verbatim into hard data. Data interpretation was based on the selective reading approach of van Manen from which six thematic statements arose. These are living the discomforts of treatment and recovery, discovering new limitations on myself; functional and emotional, my reliance on support, my financial security is threatened, my survival is at threat, and I wish I had known more. The study found that each participant had a unique experience of recovery and consequently the degree of recovery attained varied between participants. They all had a very strong desire to survive lung cancer and considered the risks of major surgery and loosing a lung to be insignificant compared to the certainty of loosing their life if they did not undergo surgery. This study provided a glimpse of what it was like for a group of patients to live the experience of life after a pneumonectomy and it provides a basis from which nurses can explore further the experiences of patients who are subjected to lung cancer surgery.

Little is known about the recovery of patients after pneumonectomy and the impact of the surgery on the lifestyle of young, employed, ex-smokers and their families. This study was conducted to address this knowledge deficit, and gather information that would help health professionals to be able to assist people facing pneumonectomy. A qualitative study using van Manens methodological approach to interpretive phenomenology was chosen, in order to capture a full and rich understanding and meaning of the phenomenon that patients live. The names, age, operation, histological cell type, stage of disease, and disease free status of potential participants were obtained from a Lung Cancer Surgical Database after obtaining ethical approval for the study. Nine participants (three females and six males) met the inclusion criteria and gave informed consent for the study. Data collection comprised of open-ended interviews that were audiotaped, then transcribed verbatim into hard data. Data interpretation was based on the selective reading approach of van Manen from which six thematic statements arose. These are living the discomforts of treatment and recovery, discovering new limitations on myself; functional and emotional, my reliance on support, my financial security is threatened, my survival is at threat, and I wish I had known more. The study found that each participant had a unique experience of recovery and consequently the degree of recovery attained varied between participants. They all had a very strong desire to survive lung cancer and considered the risks of major surgery and loosing a lung to be insignificant compared to the certainty of loosing their life if they did not undergo surgery. This study provided a glimpse of what it was like for a group of patients to live the experience of life after a pneumonectomy and it provides a basis from which nurses can explore further the experiences of patients who are subjected to lung cancer surgery.

Em cães, os estudos experimentais comparativos dos diferentes tipos de sutura para a síntese do brônquio principal são escassos, quando não ausentes nesta espécie. Além disso, existem possíveis complicações decorrentes da má cicatrização do brônquio. O objetivo deste estudo foi realizar um estudo experimental comparando-se sob o ponto de vista anatomo-patológico, paramétrico, radiológico e broncoscópico as suturas manual e mecânica em brônquio principal após pneumonectomia esquerda em cães. Foram utilizados 18 cães, sadios, machos e fêmeas, adultos, sem raça definida, pesando entre 9 e 27,5 kg. Os cães foram submetidos à intubação seletiva e toracotomia esquerda no 5º espaço intercostal, onde foi feita a pneumonectomia. Foram separados em 2 grupos de 9 cães, de acordo com o tipo de sutura empregada: Grupo A - sutura manual do coto brônquico principal esquerdo com pontos separados \"em 8\" com fio polipropileno 5-0; Grupo B - sutura mecânica do coto brônquico principal esquerdo com grampeador mecânico modelo TL-30 com grampos dispostos em fileira dupla. Cada grupo foi subdividido em 3 subgrupos de 3 animais, sendo estabelecido estudo temporal aos 7, 15 e 36 dias de pós-operatório, onde foi realizado a avaliação anatomo-patológica da cicatrização das suturas manual e mecânica, bem como, a avaliação paramétrica (antes da indução da anestesia, imediatamente após o final do ato cirúrgico, 48 horas, 7, 15 e 36 dias após o procedimento cirúrgico), avaliação radiológica ( 24 horas antes e com 7, 15 e 36 dias após o procedimento cirúrgico) e avaliação broncoscópica (após indução anestésica e com 7, 15 e 36 dias após o procedimento cirúrgico), consideradas importantes para avaliar possíveis complicações decorrentes deste tipo de procedimento cirúrgico. Estas avaliações foram realizadas de acordo com o estudo temporal nos diferentes subgrupos. A avaliação paramétrica foi realizada através da mensuração da temperatura, hematócrito, hemoglobina, freqüências cardíaca e respiratória. Na avaliação histopatológica foram avaliados qualitativamente e semi-quantitativamente a intensidade da inflamação, fibrose, vasos neoformados e a presença ou não de tecido de granulação, granuloma tipo corpo estranho e necrose. Os resultados encontrados foram analisados estatisticamente. Apesar das alterações dos índices paramétricos, todos os cães apresentaram evolução pós-operatória satisfatória. Com relação à análise histopatológica, ocorreu a formação de granuloma tipo corpo estranho no coto brônquico esquerdo em 88,9% dos cães submetidos à sutura manual e em nenhum dos cães submetidos à sutura mecânica. Houve ainda, diferença estatística significativa nos cães dos Grupos A e B em relação à intensidade da inflamação, sendo de maior intensidade nos cães submetidos à sutura manual. Os resultados obtidos mostraram não haver diferença estatística significativa nas avaliações radiográficas e broncoscópicas entre os Grupos A e B. Não foram observadas intercorrências no trans e pós-operatório. Concluiu-se que os 2 tipos de sutura promoveram cicatrização adequada do coto brônquico principal esquerdo, embora tenha ocorrido maior intensidade de inflamação e maior ocorrência de granuloma tipo corpo estranho nos cães submetidos à sutura manual, permitindo evolução paramétrica, radiológica, broncoscópica pós-operatória satisfatória e sem diferença nos cães dos Grupos A e B. / In dogs, comparative experimental studies of the different types of sutures for the synthesis of the main bronchus are scarce, when not all available in this species. Furthermore, there are possible complications due to the poor healing of the bronchus. The objective of this study was to perform an experimental study to be compared under the pathological-anatomic, parametric, radiological and bronchoscopic point of views, the manual and mechanical sutures in the main bronchus after left pneumonectomy in dogs. Eighteen adult mongrel, healthy dogs, both male and female, were utilized weighing from 9 to 27.5 kg. The dogs were submitted to a selective intubation and left thorax incision in the 5 th intercostal space where a pneumonectomy was performed. Were separated into 2 groups of 9 dogs according to the type of suture employed: Group A - a manual suture of the main left bronchial stump with separate stitches \"in 8\" with polypropylene 5-O; Group B - a mechanical suture of main left bronchial stump with a mechanical stapler, model TL-30 arranged in a double file. Each group was subdivided into 3 subgroups of 3 animals and a temporal postoperative study was established at 7, 15 and 36 days where an pathological-anatomic evaluation was made on the healing of the manual and mechanical sutures as well as a parametric evaluation (before the induction of anesthesia, immediately after the final surgical act, 48 hours, 7, 15 and 36 days after the surgical procedure), radiological evaluation (24 hours before and with 7, 15 and 36 days after the surgical procedure), and bronchoscopic evaluation (after the induction of anesthesia and with, 7, 15 and 36 days after the surgical procedure), considered important to evaluate possible complications due to this type of surgical procedure. These evaluations were made according to the temporal study in the subgroups. The parametric evaluation was made through the mensuration of temperature, hematocrit, hemoglobin, heart and respiratory rate. During the histopathological evaluation, the intensity of inflammation, fibrosis, neoformed vessels, and the presence or absence of granulation tissue, foreign body reaction and necrosis were evaluated qualitatively and semi-quantitatively. The results found were analyzed statistically. Although the difference observed in the parametric evaluations, all the dogs showed good recovery postoperative. Regarding the histopathologic analysis, foreign body reaction occured in the left bronchial stump in 88,9% of the dogs submitted to a manual suture and in none of the dogs submitted to a mechanical suture. There is still, significant statistical difference in the dogs in Groups A and B in relation to the intensity of the inflammation, the greatest intensity being in the dogs submitted to the manual suture. The results obtained showed that there was no significant statistical difference in the radiographic and bronchoscopic evaluations between Groups A and B. No intercurrences were observed in the trans and postoperative period. It is concluded that both types of sutures brought an adequate healing of the main left bronchial stump, although there was a greater intensity of inflammation and a greater occurence of foreign body reaction in the dogs submitted to the manual suture, permitting satisfactory parametric, radiological and bronchoscopic postoperative evolution and there is no difference in all of the dogs in Groups A and B.

Em cães, os estudos experimentais comparativos dos diferentes tipos de sutura para a síntese do brônquio principal são escassos, quando não ausentes nesta espécie. Além disso, existem possíveis complicações decorrentes da má cicatrização do brônquio. O objetivo deste estudo foi realizar um estudo experimental comparando-se sob o ponto de vista anatomo-patológico, paramétrico, radiológico e broncoscópico as suturas manual e mecânica em brônquio principal após pneumonectomia esquerda em cães. Foram utilizados 18 cães, sadios, machos e fêmeas, adultos, sem raça definida, pesando entre 9 e 27,5 kg. Os cães foram submetidos à intubação seletiva e toracotomia esquerda no 5º espaço intercostal, onde foi feita a pneumonectomia. Foram separados em 2 grupos de 9 cães, de acordo com o tipo de sutura empregada: Grupo A - sutura manual do coto brônquico principal esquerdo com pontos separados \"em 8\" com fio polipropileno 5-0; Grupo B - sutura mecânica do coto brônquico principal esquerdo com grampeador mecânico modelo TL-30 com grampos dispostos em fileira dupla. Cada grupo foi subdividido em 3 subgrupos de 3 animais, sendo estabelecido estudo temporal aos 7, 15 e 36 dias de pós-operatório, onde foi realizado a avaliação anatomo-patológica da cicatrização das suturas manual e mecânica, bem como, a avaliação paramétrica (antes da indução da anestesia, imediatamente após o final do ato cirúrgico, 48 horas, 7, 15 e 36 dias após o procedimento cirúrgico), avaliação radiológica ( 24 horas antes e com 7, 15 e 36 dias após o procedimento cirúrgico) e avaliação broncoscópica (após indução anestésica e com 7, 15 e 36 dias após o procedimento cirúrgico), consideradas importantes para avaliar possíveis complicações decorrentes deste tipo de procedimento cirúrgico. Estas avaliações foram realizadas de acordo com o estudo temporal nos diferentes subgrupos. A avaliação paramétrica foi realizada através da mensuração da temperatura, hematócrito, hemoglobina, freqüências cardíaca e respiratória. Na avaliação histopatológica foram avaliados qualitativamente e semi-quantitativamente a intensidade da inflamação, fibrose, vasos neoformados e a presença ou não de tecido de granulação, granuloma tipo corpo estranho e necrose. Os resultados encontrados foram analisados estatisticamente. Apesar das alterações dos índices paramétricos, todos os cães apresentaram evolução pós-operatória satisfatória. Com relação à análise histopatológica, ocorreu a formação de granuloma tipo corpo estranho no coto brônquico esquerdo em 88,9% dos cães submetidos à sutura manual e em nenhum dos cães submetidos à sutura mecânica. Houve ainda, diferença estatística significativa nos cães dos Grupos A e B em relação à intensidade da inflamação, sendo de maior intensidade nos cães submetidos à sutura manual. Os resultados obtidos mostraram não haver diferença estatística significativa nas avaliações radiográficas e broncoscópicas entre os Grupos A e B. Não foram observadas intercorrências no trans e pós-operatório. Concluiu-se que os 2 tipos de sutura promoveram cicatrização adequada do coto brônquico principal esquerdo, embora tenha ocorrido maior intensidade de inflamação e maior ocorrência de granuloma tipo corpo estranho nos cães submetidos à sutura manual, permitindo evolução paramétrica, radiológica, broncoscópica pós-operatória satisfatória e sem diferença nos cães dos Grupos A e B. / In dogs, comparative experimental studies of the different types of sutures for the synthesis of the main bronchus are scarce, when not all available in this species. Furthermore, there are possible complications due to the poor healing of the bronchus. The objective of this study was to perform an experimental study to be compared under the pathological-anatomic, parametric, radiological and bronchoscopic point of views, the manual and mechanical sutures in the main bronchus after left pneumonectomy in dogs. Eighteen adult mongrel, healthy dogs, both male and female, were utilized weighing from 9 to 27.5 kg. The dogs were submitted to a selective intubation and left thorax incision in the 5 th intercostal space where a pneumonectomy was performed. Were separated into 2 groups of 9 dogs according to the type of suture employed: Group A - a manual suture of the main left bronchial stump with separate stitches \"in 8\" with polypropylene 5-O; Group B - a mechanical suture of main left bronchial stump with a mechanical stapler, model TL-30 arranged in a double file. Each group was subdivided into 3 subgroups of 3 animals and a temporal postoperative study was established at 7, 15 and 36 days where an pathological-anatomic evaluation was made on the healing of the manual and mechanical sutures as well as a parametric evaluation (before the induction of anesthesia, immediately after the final surgical act, 48 hours, 7, 15 and 36 days after the surgical procedure), radiological evaluation (24 hours before and with 7, 15 and 36 days after the surgical procedure), and bronchoscopic evaluation (after the induction of anesthesia and with, 7, 15 and 36 days after the surgical procedure), considered important to evaluate possible complications due to this type of surgical procedure. These evaluations were made according to the temporal study in the subgroups. The parametric evaluation was made through the mensuration of temperature, hematocrit, hemoglobin, heart and respiratory rate. During the histopathological evaluation, the intensity of inflammation, fibrosis, neoformed vessels, and the presence or absence of granulation tissue, foreign body reaction and necrosis were evaluated qualitatively and semi-quantitatively. The results found were analyzed statistically. Although the difference observed in the parametric evaluations, all the dogs showed good recovery postoperative. Regarding the histopathologic analysis, foreign body reaction occured in the left bronchial stump in 88,9% of the dogs submitted to a manual suture and in none of the dogs submitted to a mechanical suture. There is still, significant statistical difference in the dogs in Groups A and B in relation to the intensity of the inflammation, the greatest intensity being in the dogs submitted to the manual suture. The results obtained showed that there was no significant statistical difference in the radiographic and bronchoscopic evaluations between Groups A and B. No intercurrences were observed in the trans and postoperative period. It is concluded that both types of sutures brought an adequate healing of the main left bronchial stump, although there was a greater intensity of inflammation and a greater occurence of foreign body reaction in the dogs submitted to the manual suture, permitting satisfactory parametric, radiological and bronchoscopic postoperative evolution and there is no difference in all of the dogs in Groups A and B.

Understanding the cellular and molecular dynamics of lung progenitors is necessary to achieve the ultimate therapeutic goal of tissue regeneration in the context of debilitating lung diseases. Alveolar type 2 cells (AT2s) of the distal lung epithelium are considered the predominant facultative progenitors of adult murine lung alveoli, the tissues responsible for gas exchange in mammals. While normally quiescent at homeostasis, AT2s can enter cell cycle and transdifferentiate into alveolar type 1 cells (AT1s) during lung repair. The kinetics of AT2 transdifferentiation into AT1s following mild insults, where alveolar architectural integrity is preserved and lung function is restored, is not completely understood. Additionally, the transcriptomic programs across all cell lineages that might regulate this process largely remain unknown. To identify putative molecular pathways activated in the epithelium and its overall niche, cell-type specific responses were characterized in a mouse model during adult lung compensatory growth following the mild injury of unilateral pneumonectomy (PNX). Histologic analyses showed proliferation of AT2s as a primary response, followed by differentiation into AT1s that peaked around day 10-12 post-PNX. Time-series single-cell RNA sequencing profiles revealed that AT2s express transitional markers such as Krt8 and Areg, consistent with previous studies. Trajectory analysis using a Continuous State Hidden Markov Model (CSHMM) predicted Hippo pathway effector Tead1 and Notch signaling target Hes1 as active transcription factors associated with the transdifferentiation of AT2s to AT1s. To verify involvement of Notch post PNX, AT2s were assessed for Notch activation using a genetic reporter, which showed an increase in the percentage of Notch-responsive AT2s post-PNX. To test potential function of Notch in AT2 transdifferentiation into AT1s, Notch signaling was inhibited in vitro in a mouse cell co-culture model which showed loss of AT2 transdifferentiation into AT1s. Single-cell RNA sequencing profiles post-PNX revealed an activated lung mesenchymal subset unique to injury that was characterized by high expression of extracellular matrix-related (ECM) genes along with low expression of Acta2 and Pdgfra. Interestingly, this mesenchymal subset included Cthrc1+ fibroblasts that expressed the highest levels of ECM genes and transcripts associated with BMP and TGFβ signaling pathways, including Fstl1, Grem1, and Tgfβ3, factors previously linked to epithelial differentiation. Immunostaining combined with in situ hybridization assays identified Cthrc1+ fibroblasts adjacent to Krt8+ transitional epithelial cells. Genetic lineage tracing of Cthrc1+ cells post-PNX revealed the persistence of their descendants after completion of compensatory lung regrowth. In summary, analysis of AT2 global transcriptomes and differentiation kinetics post-PNX revealed activated/transitional states, nascent AT1 cells, and the emergence of Cthrc1+ mesenchymal subpopulations. These results suggest that AT2s are one of the early responders to PNX stimuli and identified mesenchymal cells states that may assist in overall compensatory lung regrowth post-PNX. / 2025-09-17T00:00:00Z

A utilização das ressecções pulmonares em cães e gatos, quer sejam por lobectomia ou pneumonectomia, é realizada no intuito de cura ou paliação de processos broncopulmonares sempre que os meios conservadores de tratamento clínico sejam considerados ineficientes. Tendo em vista as significativas modificações que a pneumonectomia acarreta, novos estudos experimentais devem ser feitos para elucidar as vantagens desta intervenção cirúrgica, bem como aplicá-la com a devida segurança. O presente estudo tem como objetivo avaliar as alterações eletrocardiográficas e as alterações histopatológicas no pulmão esquerdo de cães submetidos à pneumonectomia direita. Foram utilizados dez cães, machos ou fêmeas, adultos, sem raça definida e pesando entre dez e trinta quilos. Foram avaliados os parâmetros clínicos do animal diariamente, as alterações em todas as derivações do eletrocardiograma e realizado estudo morfométrico de pulmão esquerdo bem como descrição das principais alterações histopatológicas. Foram descritos tópicos importantes da técnica cirúrgica que colaboram na prevenção de intercorrências trans e pós-operatórias. Todos os animais apresentaram boa evolução pós-operatória. Quanto à análise eletrocardiográfica, apenas um animal apresentou alteração de relevância clínica, sendo a ausência de alterações, a maioria dos casos. Presenciamos um caso de Complexos Ventriculares Prematuros decorrente à parada cardiorrespiratória revertida com sucesso. Verificamos diminuição da amplitude dos Complexos QRS nos primeiros 14 dias, retornado após 60 dias de pós-operatório. Quanto à descrição histopatológica, foram presenciados processos de hiperinsuflação ou alterações parenquimatosas não expressivas. Na análise morfométrica,as artérias intra-acinares indicaram aumento significante da porcentagem de espessura após pneumonectomia direita. As artérias com diâmetro 0-50 µm apresentaram os maiores valores tanto nos períodos pré e pós-operatório, mas a taxa de aumento (%) foi mais evidente nas artérias com diâmetro maior de 100 µm. / The intention of the use of pulmonary resections in dogs and cats, either lobectomy or pneumonectomy, is the cure or palliation of bronchopulmonary processes whenever the conservative clinical treatment means are considered ineffective. Bearing in mind the significant alterations that the pneumonectomy causes, new experimental studies must be done to elucidate the advantages of this surgical intervention, as well as perform it without any risk. The aim of the current study is to evaluate both the eletrocardiographical and the histopathological alterations in the lungs of dogs that were undergone a right pneumonectomy. Ten either male or female adult mongrel dogs weighing between ten and thirty kilos were investigated. The clinical parameters of the animals and the alterations in every eletrocardiogram derivation were evaluated day after day, and a left lung morphometrical study and the description of the main histopathological alterations were made, as well. Important topics of the surgical technique that contribute to prevent the trans and post-operative complications were described. All the animals presented a good post-operative outcome. As for the eletrocardiographical analysis, few of them were of clinical significance and in most cases there were no alterations. We observed a premature ventricular complex case resulted from a cardiorrespiratory arrest that was reverted to successfully. We found out decrease of QRS Complex Amplitude on the 0-14 days, and it returned to normal after sixty post-operative days. As for histopathological description, neither significant hiperinsuflation processes nor parenquimatous alterations were practically observed. In the morphometric analysis, the intra-acinar arteries showed, a significant increase of the thickness percentage after right pneumonectomy. The arteries with diameter 0-50µm presented the most values either period pre or post-operative, but increase rate (%) was more evident in the greater than 100 µm diameter arteries.

Em cães, a comprovação da real viabilidade da pneumonectomia direita, bem como, o estudo das complicações resultantes deste procedimento cirúrgico, tornam-se importantes diante da pequena quantidade de estudos na literatura específicos sobre pneumonectomia nesta espécie. O objetivo deste trabalho foi realizar um estudo experimental para avaliar a viabilidade da pneumonectomia direita em cães, através da avaliação paramétrica, hemogasométrica, ecocardiográfica, radiográfica, broncoscópica e da mecânica respiratória. Foram utilizados 10 cães, sadios, machos e fêmeas, adultos, sem raça definida, pesando entre 13 e 32 kg. Todos os cães foram submetidos à intubação seletiva e toracotomia direita no 5º espaço intercostal, onde foi realizada a pneumonectomia. Foi realizado estudo temporal aos sete, 30 e 60 dias de pós-operatório, onde foi feita avaliação ecocardiográfica, radiográfica e broncoscópica. A avaliação paramétrica e hemogasométrica foi realizada antes da indução anestésica, uma hora após extubação, 48 horas, sete, 30 e 60 dias após o procedimento cirúrgico. A avaliação da mecânica respiratória foi realizada antes da indução anestésica, durante a cirurgia, 48 horas, sete, 30 e 60 dias após o procedimento cirúrgico. Estas avaliações foram consideradas importantes para determinar as possíveis complicações relacionadas com a técnica anestésica, cirúrgica, assim como, as complicações resultantes deste procedimento cirúrgico. Os resultados encontrados foram analisados estatisticamente. Apesar das alterações dos índices paramétricos, hemogasométricos e da mecânica respiratória, todos os cães apresentaram compensação das trocas gasosas após retirada do pulmão direito. Em relação a avaliação da mecânica respiratória, os volumes pulmonares não se modificam de maneira acentuada. Ocorreu aumento das pressões de pico e resistência das vias aéreas devido ao emprego da sonda de duplo lúmen e ressecção pulmonar. Não houve diferença significativamente estatística nos níveis da pressão sistólica e média no tronco pulmonar. Entretanto, alguns cães apresentaram hipertensão pulmonar leve e transitória, sendo que o período de maior incidência foi aos 30 dias de pós-operatório. A fração de ejeção do ventrículo direito manteve-se normal durante o estudo. No entanto, nos mesmos cães que apresentaram hipertensão pulmonar, houve diminuição significativa da fração de ejeção do ventrículo direito aos 60 dias de pós-operatório. Na avaliação radiográfica, observamos que a expansão do pulmão remanescente causou deslocamento do coração e pulmão para hemitórax direito. Nas imagens broncoscópicas pós-operatórias não foram observadas quaisquer sinais de infecção, deiscência, fístula e estenose da sutura em coto brônquico. Concluiu-se que a realização da pneumonectomia direita é plenamente viável no cão, permitindo evolução paramétrica, hemogasométrica, ecocardiográfica, radiográfica, broncoscópica e da mecânica respiratória satisfatória em todos os cães. / In dogs, the evidence of the viability of right pneumonectomy, as well as the study of the complications resulting from surgical procedure, are very important against the small quantity of specific studies on pneumonectomy in this species. The objective of this project was carrying out an experimental study to evaluate the viability of right pneumonectomy in dogs, through parametric, hemogasometric, echocardiographic, radiographic, broncoscopic and mechanical respiratory evaluation. Ten adult mongrel, healthy dogs, both male and female were utilited weighing from 13 to 32 kg. The dogs were submitted to selective intubation and right thoracotomy at the 5th intercostal space, where the pneumonectomy was performed. A temporal study was made in 7, 30 and 60 days after the surgery, where echocardiographic, radiografic and bronchoscopic evaluation were done. The parametric and hemogasometric evaluations was made before anesthetic induction, one hour after extubation, in 48 hour, seven, 30 and 60 days after the surgical procedure. The mechanical respiratory evaluation was before anesthetic induction, during surgery, 48 hour, seven, 30 and 60 days after the surgical procedure. These evaluations were considered important to determine the probable complications connected to the anesthetic, surgical techniques, as well as the resulting complications from these procedures. The results were analyzed statistically. Besides the alterations of the parametric, hemogasometric and mechanical respiratory rates, all the dogs presented compensations on the gaseous exchanges after removing right lung. Regarding the mechanical respiratory evaluation, the pulmonary volume has not changed accentually. There was an increase of the peak pressures and resistance of the respiratory tract due to the use of a double lumen probe and lung ressection. There wasn\'t any significant statistically difference on the levels of systolic and average pressure on the pulmonary trunk. However, some dogs showed light and transitory pulmonary hypertension, and the highest occurrence period happened 30 days after surgery. The fraction of ejection of the right ventricle remained normal during the study. However, at the same dogs who presented pulmonary hypertension, there was a significant decrease of the fraction of the right ventricle 60 days after surgery. On the radiographic evaluation, we have observed that the expansion of the remaining lung caused heart and lung displacement to the right hemithorax. Any signs of infection, dehiscence, fistula or suture stenosis in the main right bronchial stump were observed on the post-operative bronchoscopic images. It follows that the right pneumonectomy is completely feasible the dogs, allowing a parametric, hemogasometric, echocardiographic, radiographic, bronchoscopic and mechanical respiratory satisfactory evaluation in all the dogs.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

Em cães, a comprovação da real viabilidade da pneumonectomia direita, bem como, o estudo das complicações resultantes deste procedimento cirúrgico, tornam-se importantes diante da pequena quantidade de estudos na literatura específicos sobre pneumonectomia nesta espécie. O objetivo deste trabalho foi realizar um estudo experimental para avaliar a viabilidade da pneumonectomia direita em cães, através da avaliação paramétrica, hemogasométrica, ecocardiográfica, radiográfica, broncoscópica e da mecânica respiratória. Foram utilizados 10 cães, sadios, machos e fêmeas, adultos, sem raça definida, pesando entre 13 e 32 kg. Todos os cães foram submetidos à intubação seletiva e toracotomia direita no 5º espaço intercostal, onde foi realizada a pneumonectomia. Foi realizado estudo temporal aos sete, 30 e 60 dias de pós-operatório, onde foi feita avaliação ecocardiográfica, radiográfica e broncoscópica. A avaliação paramétrica e hemogasométrica foi realizada antes da indução anestésica, uma hora após extubação, 48 horas, sete, 30 e 60 dias após o procedimento cirúrgico. A avaliação da mecânica respiratória foi realizada antes da indução anestésica, durante a cirurgia, 48 horas, sete, 30 e 60 dias após o procedimento cirúrgico. Estas avaliações foram consideradas importantes para determinar as possíveis complicações relacionadas com a técnica anestésica, cirúrgica, assim como, as complicações resultantes deste procedimento cirúrgico. Os resultados encontrados foram analisados estatisticamente. Apesar das alterações dos índices paramétricos, hemogasométricos e da mecânica respiratória, todos os cães apresentaram compensação das trocas gasosas após retirada do pulmão direito. Em relação a avaliação da mecânica respiratória, os volumes pulmonares não se modificam de maneira acentuada. Ocorreu aumento das pressões de pico e resistência das vias aéreas devido ao emprego da sonda de duplo lúmen e ressecção pulmonar. Não houve diferença significativamente estatística nos níveis da pressão sistólica e média no tronco pulmonar. Entretanto, alguns cães apresentaram hipertensão pulmonar leve e transitória, sendo que o período de maior incidência foi aos 30 dias de pós-operatório. A fração de ejeção do ventrículo direito manteve-se normal durante o estudo. No entanto, nos mesmos cães que apresentaram hipertensão pulmonar, houve diminuição significativa da fração de ejeção do ventrículo direito aos 60 dias de pós-operatório. Na avaliação radiográfica, observamos que a expansão do pulmão remanescente causou deslocamento do coração e pulmão para hemitórax direito. Nas imagens broncoscópicas pós-operatórias não foram observadas quaisquer sinais de infecção, deiscência, fístula e estenose da sutura em coto brônquico. Concluiu-se que a realização da pneumonectomia direita é plenamente viável no cão, permitindo evolução paramétrica, hemogasométrica, ecocardiográfica, radiográfica, broncoscópica e da mecânica respiratória satisfatória em todos os cães. / In dogs, the evidence of the viability of right pneumonectomy, as well as the study of the complications resulting from surgical procedure, are very important against the small quantity of specific studies on pneumonectomy in this species. The objective of this project was carrying out an experimental study to evaluate the viability of right pneumonectomy in dogs, through parametric, hemogasometric, echocardiographic, radiographic, broncoscopic and mechanical respiratory evaluation. Ten adult mongrel, healthy dogs, both male and female were utilited weighing from 13 to 32 kg. The dogs were submitted to selective intubation and right thoracotomy at the 5th intercostal space, where the pneumonectomy was performed. A temporal study was made in 7, 30 and 60 days after the surgery, where echocardiographic, radiografic and bronchoscopic evaluation were done. The parametric and hemogasometric evaluations was made before anesthetic induction, one hour after extubation, in 48 hour, seven, 30 and 60 days after the surgical procedure. The mechanical respiratory evaluation was before anesthetic induction, during surgery, 48 hour, seven, 30 and 60 days after the surgical procedure. These evaluations were considered important to determine the probable complications connected to the anesthetic, surgical techniques, as well as the resulting complications from these procedures. The results were analyzed statistically. Besides the alterations of the parametric, hemogasometric and mechanical respiratory rates, all the dogs presented compensations on the gaseous exchanges after removing right lung. Regarding the mechanical respiratory evaluation, the pulmonary volume has not changed accentually. There was an increase of the peak pressures and resistance of the respiratory tract due to the use of a double lumen probe and lung ressection. There wasn\'t any significant statistically difference on the levels of systolic and average pressure on the pulmonary trunk. However, some dogs showed light and transitory pulmonary hypertension, and the highest occurrence period happened 30 days after surgery. The fraction of ejection of the right ventricle remained normal during the study. However, at the same dogs who presented pulmonary hypertension, there was a significant decrease of the fraction of the right ventricle 60 days after surgery. On the radiographic evaluation, we have observed that the expansion of the remaining lung caused heart and lung displacement to the right hemithorax. Any signs of infection, dehiscence, fistula or suture stenosis in the main right bronchial stump were observed on the post-operative bronchoscopic images. It follows that the right pneumonectomy is completely feasible the dogs, allowing a parametric, hemogasometric, echocardiographic, radiographic, bronchoscopic and mechanical respiratory satisfactory evaluation in all the dogs.