Thoracoscopic thoracic duct ligation and thoracoscopic pericardectomy for treatment of chylothorax in dogs

David A Allman, Maryann G Radlinsky, Alan G Ralph, Clarence A Rawlings
Veterinary Surgery 2010, 39 (1): 21-7

OBJECTIVE: To report the use of thoracoscopic thoracic duct ligation (TDL) and pericardectomy for treatment of chylothorax.

STUDY DESIGN: Case series.

ANIMALS: Dogs with chylothorax (n=12).

METHODS: Dogs with secondary or idiopathic chylothorax had thoracoscopy performed in sternal recumbency through 3 portals in the caudal right hemithorax for TDL and were then repositioned in dorsal recumbency for pericardectomy. Portals were placed in the 5th and 7th intercostal spaces of the right hemithorax with 1 transdiaphragmatic portal in the right paraxiphoid position. Follow-up was performed by recheck examination or telephone interview to determine outcome.

RESULTS: Seven dogs (58%) had idiopathic chylothorax; 6 dogs (85.7%) had complete resolution of their effusion, whereas only 2 of the 5 nonidiopathic dogs (40%) had complete resolution.

CONCLUSIONS: Thoracoscopy is minimally invasive, provides excellent observation, and allows for ligation of the thoracic duct in the caudal thorax. Patients with idiopathic chylothorax may have a better prognosis after TDL and pericardectomy than dogs with nonidiopathic chylothorax.

CLINICAL RELEVANCE: Thoracoscopy for ligation of the thoracic duct and pericardectomy is an acceptable surgical technique for treatment of chylothorax.

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