Chylothorax

Question 1

Stockdale, JAVMA, 2018:
Thoracic duct ligation + subphrenic pericardiectomy with or without cisterna chyli ablation for chylothorax
Effect of the addition of cisterna chyli ablation?

Answer 1

Stockdale, JAVMA, 2018:
Increased duration of surgery with no better outcome than achieved with thoracic duct ligation + subphrenic pericardiectomy alone

Question 2

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?

Answer 2

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

Question 3

Rengert
Morphology of Cisterna Chyli
VetSurg 2021

Answer 3

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

Question 4

Stockdale
Sx for chylothorax in cats
JAVMA 2018

Answer 4

Duration of surgery longer with TDL + SPC + CCA (125 m) vs. TDL + SPC (80 m)

MST
~TDL + SPC: 774 d
~TDL + SPC + CCA: 380d

Question 5

Bleakley
Median sternotomy vs. intercostal thoracotomy
VetSurg 2018

Answer 5

Median Sternotomy
>chest fluid production
>alveolar arterial pressure
>complications requiring intervention

Question 6

Mayhew
Thoracoscopic TDL + SPC in dogs
VetSurg 2019

Answer 6

Death 2/39

Conversion
TDL 3%
Pericardectomy 11%

Resolution of pleural effusion 95%

Reoccurrence 9%

Question 7

Kanai, VRU 2021

How many dogs had thoracic duct apparent?

The proposed reasons

Answer 7

7 of 14 had thoracic duct appartent

3 missed ducts (sleeping: collapsed at the time of original CT)
4 bypass formation