Toraks Bölgesinin Cerrahi Hastalıkları
Özet
Toraks duvarı ve toraks boşluğu içerisinde yer alan organlar, yaşamın sürdürülebilmesi açısından hayati öneme sahiptir. Bu nedenle torasik bölge hastalıkları, çoğu zaman acil müdahale gerektiren ve yönetiminde yüksek dikkat ile multidisipliner yaklaşımın esas olduğu klinik tablolar arasında yer almaktadır. Toraks duvarı ve toraks boşluğunda karşılaşılan patolojik durumlar, uygun ve zamanında tedavi uygulanmasına rağmen ciddi morbidite ve mortaliteye yol açabilmektedir. Toraks travmalarına bağlı olarak gelişen plevral efüzyonlar ile diyafram hernileri, bu bölgede en sık karşılaşılan ve cerrahi girişim gerektiren önemli hastalıklar arasında yer almaktadır. Bu bölümde, toraks bölgesine ait cerrahi hastalıkların etiyolojisi, klinik bulguları, tanı yöntemleri ve güncel tedavi yaklaşımları ayrıntılı ve sistematik bir biçimde ele alınacaktır.
Referanslar
Olsen D. Thoracic wall and sternum. In: Bojrab MJ, Monnet E (eds.) Mechanisms of Disease in Small Animal Surgery. 3rd ed. St. Louis: Elsevier; 2017.
Evans HE. Guide to the dissection of the dog. 7th ed. Philadelphia: Saunders/Elsevier; 2009.
Losonsky JM, Prasse KW. Dyspnea in the cat. Part I. Radiographic aspects of intrathoracic causes involving the pleural space. Feline Pract. 1978;8:35.
Tillson DM. Thoracic surgery; important considerations and practical steps. The Veterinary clinics of North America. Small animal practice. 2015;45(3): 489–506. doi:10.1016/j.cvsm.2015.01.007
Price AK, Mathews KG. A single left fourth intercostal thoracotomy approach for resolution of idiopathic chylothorax with thoracic duct ligation and pericardiectomy: a preliminary clinical study in two dogs. Front Vet Sci. 2024;11:1463939. doi:10.3389/fvets.2024.1463939
Burton CA, White RN. Review of the technique and complications of median sternotomy in the dog and cat. J Small Anim Pract. 1996;37(11): 516–522. doi:10.1111/j.1748-5827.1996.tb02311.x
Salcı H. Toraks bölgesinin cerrahi hastalıkları. In: Görgül OS (ed.) Özel Cerrahi. Malatya: Medipres Yayıncılık; 2012. p.197-226.
McCarthy TC. Diagnostic thoracoscopy. Clin Tech Small Anim Pract. 1999;14(4): 213–219.
Bianchi A, Collivignarelli F, Paolini A, et al. Thoracoscopic assisted PleuralPortTM application in seven dogs affected by chronic pleural effusion. Vet Sci. 2023;10: 324. doi:10.3390/vetsci10050324
Radlinsky MA. Thoracoscopy in the cat: an up-and-coming diagnostic and therapeutic procedure. J Feline Med Surg. 2014;16: 27–33.
Vachon AM, Fischer AT. Thoracoscopy in the horse: diagnostic and therapeutic indications in 28 cases. Equine Vet J. 1998;30(6): 467–475. doi:10.1111/j.2042-3306.1998.tb04521.x
Salcı H, Yılmaz Z, Bayram AS, et al. Medical and surgical treatment of chylothorax in a dog with right-sided heart failure. Turk J Vet Anim Sci. 2009;33(2): 165–170.
Jiménez Peláez M, Vicens Zanoguera L. Thoracic trauma. Veterinary Focus. 2015;25(3): 39–46.
Lux CN, Culp WTN, Mellema MS, et al. Perioperative mortality rate and risk factors for death in dogs undergoing surgery for treatment of thoracic trauma: 157 cases (1990–2014). J Am Vet Med Assoc. 2018;252(9): 1097–1107. doi:10.2460/javma.252.9.1097
Simpson SA, Syring R, Otto CM. Severe blunt trauma in dogs: 235 cases (1997–2003). J Vet Emerg Crit Care (San Antonio). 2009;19: 588–602.
Shamir MH, Leisner S, Klement E, et al. Dog bite wounds in dogs and cats: a retrospective study of 196 cases. J Vet Med A Physiol Pathol Clin Med. 2002;49: 107–112.
Worth AJ, Machon RG. Traumatic diaphragmatic herniation: pathophysiology and management. Compend Contin Educ Vet. 2005;27: 178–190.
Salcı H, Bayram AS, Cellini N, et al. Evaluation of thoracic trauma in dogs and cats: a review of seventeen cases. Iran J Vet Res. 2010;11(4): Ser. No.33.
Spackman CJ, Caywood DD, Feeney DA, et al. Thoracic wall and pulmonary trauma in dogs sustaining fractures as a result of motor vehicle accidents. J Am Vet Med Assoc. 1984;185: 975–977.
Sullivan M, Lee R. Radiological features of 80 cases of diaphragmatic rupture. J Small Anim Pract. 1989;30: 561–566.
Houlton JE, Dyce J. Does fracture pattern influence thoracic trauma? A study of 300 canine cases. Vet Comp Orthop Traumatol. 1992;3: 5–7.
Anderson M, Payne JT, Mann FA, et al. Flail chest: pathophysiology, treatment, and prognosis. Compend Contin Educ Vet. 1993;15: 65–74.
Scheepens ETF, Peeters ME, L’Eplattenier HF, et al. Thoracic bite trauma in dogs: a comparison of clinical and radiological parameters with surgical results. J Small Anim Pract. 2006;47: 721–726.
Hardie RJ. Pneumothorax. In: Monnet E (ed.) Textbook of Small Animal Soft Tissue Surgery. Chichester: John Wiley & Sons; 2013. p. 766–781.
Brockman DJ, Puerto DA. Pneumomediastinum and pneumothorax. In: King LG (ed.) Textbook of Respiratory Disease in Dogs and Cats. St. Louis: Elsevier; 2004. p. 616–621.
Hackner SG. Emergency management of traumatic pulmonary contusions. Compend Contin Educ Vet. 1995;17: 677–686.
Marques AIDC, Tattersall J, Shaw DJ, et al. Retrospective analysis of the relationship between time of thoracostomy drain removal and discharge time. J Small Anim Pract. 2009;50: 162–166.
Samsar E, Akın F. Özel Cerrahi. Malatya: Medipres Yayıncılık; 2006. p. 91–97.
Backman A, Marvel SJ. Needle-scope guided surgical correction of pectus excavatum in a kitten. Vet Surg. 2025;54(7): 1485–1492. doi:10.1111/vsu.14323
Komsta R, Łojszczyk A, Dębiak P, et al. Computed tomographic evaluation of pectus excavatum in 14 cats. PLoS ONE. 2022;17(1): e0262866. doi:10.1371/journal.pone.0262866
Pereira KHNP, Fuchs KdM, Terçariol LAA, et al. Two types of management for the noninvasive treatment of pectus excavatum in neonatal puppies—case reports. Animals. 2023;13: 906. doi:10.3390/ani13050906
Yılmaz Z, Kocatürk M. Bir kedide idiopatik şilotoraksın medikal tedavisinde oktreotid’in etkisi. Türk Vet Cer Derg. 2023;1(2): 19–22.
Reeves LA, Anderson KM, Luther JK, et al. Treatment of idiopathic chylothorax in dogs and cats: a systematic review. Vet Surg. 2020;49(1): 70–79. doi:10.1111/vsu.13322
Demetriou JL, Foale RD, Ladlow J, et al. Canine and feline pyothorax: a retrospective study of 50 cases in the UK and Ireland. J Small Anim Pract. 2002;43(9): 388–394. doi:10.1111/j.1748-5827.2002.tb00089.x
Johnson LR, Epstein SE, Reagan KL, et al. Etiology and effusion characteristics in 29 cats and 60 dogs with pyothorax (2010–2020). J Vet Intern Med. 2023;37(3): 1155–1165. doi:10.1111/jvim.16699
Korkmaz UF, Kahraman D, Bozkurt MF, et al. A case and treatment of resistant pyothorax in a cat. Van Vet J. 2023;34(1): 81–85. doi:10.36483/vanvetj.1248328
Stillion JR, Letendre JA. A clinical review of the pathophysiology, diagnosis, and treatment of pyothorax in dogs and cats. J Vet Emerg Crit Care (San Antonio). 2015;25(1): 113–129. doi:10.1111/vec.12274
Polat E, Uztimür H. Evcil hayvanlarda timoma. In: Sarıtaş ZK (ed.) Veteriner Cerrahi Araştırmaları ve Sürdürülebilirlik I. Lyon: Livre de Lyon; 2025. p. 133–146.
Günay C, Polat E, Sağlıyan A. Diaphragmatic hernia and its treatment in a stray dog. Veterinary Journal of Kastamonu University. 2022;1(2): 17–24.
Zamirbekova N, Uzunlu EO, Arıcan M. Kedi ve köpeklerde travmatik hernia diyaframatika: 40 olgu. Bozok Veterinary Sciences. 2020;1(1): 7–12.