Caudal median sternotomy and diaphragmotomy in addition to midline celiotomy for liver lobectomy: Description of surgical technique and clinical outcome in 22 dogs.

Abstract

BACKGROUND: During liver lobectomy, exposure of the liver hilus may be improved with the addition of a caudal median sternotomy and diaphragmotomy. This study aimed to report the surgical technique for this procedure and its clinical outcomes when performed in dogs. METHODS: The clinical records of dogs undergoing a caudal median sternotomy for liver lobectomy between 2010 and 2023 were retrospectively reviewed. Data extracted from these records included signalment, preoperative findings, whether the lobectomy performed was right, central or left divisional, complications, histopathology and outcomes. Median survival times (MSTs) and complications were then compared between lobectomy division groups. RESULTS: Twenty-two dogs were included. The division of liver lobectomy was central in 12 dogs, right in nine dogs and left in one dog. Most (n = 21) dogs had hilar dissection with finger fracture. Intraoperative haemorrhage requiring a transfusion occurred in 12 dogs, including one dog that died intraoperatively. Twenty-one dogs survived to discharge. Postoperative complications were minor in 14 dogs, major in seven dogs and catastrophic in one dog. The MST was 562 days. The complication rate and MST were not significantly different between central and right divisional lobectomies. LIMITATION: This was a retrospective study. As such, the treatment protocols and postoperative care were not standardised. CONCLUSION: Most dogs undergoing this procedure had a good outcome. Although intraoperative haemorrhage and postoperative complications were common, they were generally manageable. Therefore, this procedure should be considered for challenging liver lobectomies.