Study supports ligature-based lung lobectomy in dogs and cats: full analysis

A new retrospective study in Veterinary Surgery found low perioperative complication rates in dogs and cats undergoing total lung lobectomy with a hilar circumferential ligature, a suture-based technique that can serve as an alternative to stapling devices. Across 80 patients and 94 lung lobes, the reported intraoperative hemorrhage rate was 4.3%, with outcomes supporting both commercial pre-tied ligature loops and hand-tied circumferential ligatures as viable options in clinical cases. (pmc.ncbi.nlm.nih.gov)

The study arrives as veterinary thoracic surgery continues to weigh the benefits of stapled, thoracoscopic, and open approaches against instrument cost, patient size, and access to specialized equipment. Stapling devices are widely used in lung lobectomy, but the authors note that most are designed for human patients, not dogs and cats, which can create practical limitations in smaller veterinary patients. Recent veterinary literature has also explored stapler-assisted open lung lobectomy, thoracoscopic stapled techniques, and alternative hilar sealing methods, reflecting broader interest in matching closure methods to case needs and anatomy. (pmc.ncbi.nlm.nih.gov)

In the new report, investigators reviewed medical records for dogs and cats that underwent surgery for total lung lobectomy using a hilar circumferential ligature, either with a commercial pre-tied ligature loop or a hand-tied knot. The study population included 65 dogs and 15 cats, for a total of 94 lung lobectomies. The main reported complication was intraoperative hemorrhage in 4 of 94 lobectomies. According to the paper, that low overall complication rate supports use of the technique in veterinary patients, and the study did not identify a significant difference in hemorrhage outcomes between the two ligature methods. (pmc.ncbi.nlm.nih.gov)

The findings are especially useful when viewed alongside another Veterinary Surgery retrospective study of open thoracic lung lobectomy using the Endo GIA stapler in 46 procedures across 37 dogs and cats. That study reported 17.4% minor intraoperative complications and no major intraoperative complications, concluding the device was a valid alternative for open-approach lung lobectomy. Taken together, the two studies suggest that both stapled and circumferential ligature techniques can be performed safely in appropriately selected cases, though they were not designed as head-to-head comparisons. (pubmed.ncbi.nlm.nih.gov)

Published expert commentary specifically on the new hilar ligature paper appears limited so far, but the broader literature gives context for why the study may resonate with surgeons. Reviews of minimally invasive veterinary thoracic oncology describe staplers as central tools in thoracoscopic lung lobectomy, while case reports and cadaveric work in cats and dogs continue to test alternatives that may reduce instrument constraints or improve access in smaller patients. That broader pattern suggests ongoing interest in techniques that preserve safety while improving flexibility and potentially lowering procedural cost. This is an inference based on the direction of the recent literature, rather than a direct statement from outside commentators. (veterinaryoncology.biomedcentral.com)

Why it matters: For veterinary professionals, this study strengthens the evidence base for a technique that may be more accessible than stapler-based lobectomy in some settings. Referral hospitals and specialty practices often have multiple closure options available, but general access, instrument cost, and patient size can all shape intraoperative decision-making. A low reported hemorrhage rate with hilar circumferential ligation may give surgeons added confidence when using a suture-based method, particularly in smaller patients or when stapling devices are less practical. It also gives teams a more grounded way to discuss procedural planning, risk, and cost with pet parents. (pmc.ncbi.nlm.nih.gov)

What to watch: The next step is more direct comparison, ideally prospective or multicenter work that evaluates ligature and stapler techniques side by side, with attention to patient selection, surgeon experience, operative time, cost, air leak risk, and longer-term outcomes after discharge. Until then, this study adds meaningful support for hilar circumferential ligation as a credible option in the thoracic surgery toolkit. (pmc.ncbi.nlm.nih.gov)