Intercostal thoracotomy in 20 dogs: muscle-sparing versus traditional techniques

Abstract

The levels of pain, duration of approaching and closure, and surgical exposure associated with intercostal thoracotomy were compared between muscle-sparing and traditional techniques in 20 dogs. Postoperative pain was assessed based on numerical pain scores using behavioral observation, heart rate, respiratory rate, and wound palpation. Time for approaching and closure were measured, and the extent of intrathoracic organ exposure for the surgical procedures was described for each technique. There were significant differences in numerical pain scores at 2 h as well as 1, 2, 3, 4, 5, 6, and 7 days after surgery between the two groups (p < 0.0001). There was no significant (p = 0.725) difference in times for approaching and closure between the two groups. Compared to the traditional method, the muscle-sparing technique also achieved the desired exposure without compromising exposure of the target organs. Our results suggest that the muscle-sparing technique is more effective than the traditional method for providing a less painful recovery during the first 7 days after intercostal thoracotomy. Additionally, the muscle-sparing technique is as effective as the traditional modality for providing an appropriate time for approaching and closure during intercostal thoracotomy as well as adequate organ exposure for the surgical procedures.

Keywords: dogs; intercostal thoracotomy; muscle-sparing.

Fig. 1. Muscle-sparing technique. (A) Skin, subcutaneous tissue, and cutaneous trunci muscle incisions extended from 2 cm ventral to the rib head to the area near the sternum. (B) The ventral border of the latissimus dorsi muscle was bluntly dissected. (C) The latissimus dorsi muscle was retracted dorsally using a Senn-Miller retractor and the scalenus muscle was detached from the rib. (D) Serrations of the serratus ventralis muscle were split at the intended intercostal space and a Senn-Miller retractor was placed for pectoral muscles retraction. (E) A Balfour retractor was placed for rib and muscle retraction. Side blades were used for rib retraction, and a center blade was used for retraction of the latissimus dorsi muscle and serratus ventralis muscle.