Chylothorax Flashcards
Stockdale, JAVMA, 2018:
Thoracic duct ligation + subphrenic pericardiectomy with or without cisterna chyli ablation for chylothorax
Effect of the addition of cisterna chyli ablation?
Stockdale, JAVMA, 2018:
Increased duration of surgery with no better outcome than achieved with thoracic duct ligation + subphrenic pericardiectomy alone
Barker, Vet Surg, 2018:
Fluoroscopically guided thoracostomy tube placement vs blind placement
What % of dogs that underwent blind placement of thoracostomy tubes had major errors in placement that required removal and replacement?
What % of dogs that underwent fluoroscopically guided thoracostomy tube placement required tube replacement?
Barker, Vet Surg, 2018:
20% of dogs that underwent blind placement of thoracostomy tubes had major errors in placement that required removal and replacement
0% of dogs that underwent fluoroscopically guided thoracostomy tube placement required tube replacement
Rengert
Morphology of Cisterna Chyli
VetSurg 2021
Chylothorax dogs
~more branches
~occupied paremitum 2 x unaffected dogs
~cross-sectional area of cisterna chyli 2x smaller in affected
Branches dorsal or to right of aorta
Stockdale
Sx for chylothorax in cats
JAVMA 2018
Duration of surgery longer with TDL + SPC + CCA (125 m) vs. TDL + SPC (80 m)
MST
~TDL + SPC: 774 d
~TDL + SPC + CCA: 380d
Bleakley
Median sternotomy vs. intercostal thoracotomy
VetSurg 2018
Median Sternotomy
>chest fluid production
>alveolar arterial pressure
>complications requiring intervention
Mayhew
Thoracoscopic TDL + SPC in dogs
VetSurg 2019
Death 2/39
Conversion
TDL 3%
Pericardectomy 11%
Resolution of pleural effusion 95%
Reoccurrence 9%
Kanai, VRU 2021
How many dogs had thoracic duct apparent?
The proposed reasons
7 of 14 had thoracic duct appartent
3 missed ducts (sleeping: collapsed at the time of original CT)
4 bypass formation