Segmentectomia pulmonar anatômica em cães: descrição da técnica cirúrgica em modelos cadavéricos.

Abstract

Anatomic Pulmonary Segmentectomy (APS) is a widely performed surgical technique in human medicine and consists of the resection of a specific segment of pulmonary parenchyma after isolation, ligation, and division of the bronchial, arterial, and venous segments supplying that defined region of the parenchyma, through correct identification and division of the intersegmental plane. The technique aims to preserve healthy pulmonary parenchyma during surgical resection by respecting anatomical landmarks, being particularly indicated for patients with functional limitations in the affected organ, thereby reducing morbidity and mortality as well as unnecessary removal of viable tissue, while ensuring locoregional tumor control. Despite its recognized benefits in humans, the application of this surgical technique has not yet been described in the veterinary literature for the canine species. Therefore, the present study aimed to describe the APS technique in a bronchopulmonary segment of the right caudal lobe in ex vivo canine lungs. To evaluate its experimental application and feasibility, dissection of the segmental hilum was performed, the intersegmental plane was identified using the bronchial inflation-deflation maneuver for resection of the target bronchopulmonary segment, followed by mechanical suturing of the remaining parenchyma and functional assessment through the aerostasis test under positive ventilatory pressures. Variables such as sex, body weight (kg), body condition score (1–9), Euclidean distance from the carina to the segmental bronchus (cm), and leakage pressure (mmHg) were described and analyzed using Pearson’s correlation, with a significance level of p < 0.05. APS using the bronchial inflation-deflation maneuver was experimentally applicable to ex vivo canine lungs, allowing adequate aerostasis, as all evaluated models exhibited leakage pressures (mean 27.77 ± 5.648 mmHg) above the established physiological limit (14.7 mmHg). A strong positive correlation was observed between body weight and the Euclidean distance from the carina to the segmental bronchus (r = 0.7237; p = 0.0001), highlighting the influence of body size on canine pulmonary morphology and potentially aiding in the planning of segmental surgical procedures. In conclusion, APS demonstrated experimental feasibility when applied to canine lungs, providing preliminary evidence supporting its potential translation to thoracic surgery in dogs, representing a potential advancement in the surgical management of these animals.