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Single paracostal approach to thoracic duct and cisterna chyli: experimental study and case series.
MedLine Citation:
PMID:  22380664     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: To-determine the feasibility of a single paracostal abdominal approach for thoracic duct ligation (TDL) and cisterna chyli ablation (CCA) in dogs with chylothorax.
STUDY DESIGN: Observational study and prospective case series.
ANIMALS: Normal dogs (n = 5) and dogs with chylothorax (n = 8).
METHODS: A single paracostal approach with transdiaphragmatic extension for TDL and CCA was developed experimentally (n = 5) and used in 8 clinical cases with subtotal pericardectomy (SPE) performed in 4 dogs. Surgery time, complications, hospitalization time, outcome, and follow-up of clinical cases were recorded.
RESULTS: Exposure of relevant anatomy was excellent; vital lymphatic staining facilitated identification of lymphatic structures. In clinical cases, mean surgery time for TDL + CCA was 136 minutes. Mean hospitalization time was 3.1 days. Seven of 8 cases survived, with 1 dog dying of heart failure shortly after discharge. One dog required a second (left) paracostal approach to ligate 2 more lymphatic vessels. On follow-up (median, 7 months; range, 2-20 months), there was complete resolution of chylothorax in 6 dogs.
CONCLUSIONS: A single paracostal approach provides excellent exposure of cisterna chyli, caudal thoracic duct, and intestinal lymphatics. This approach eliminates the need for repositioning during combined TDL + CCA procedures and avoids an intercostal thoracotomy.
Authors:
Benjamin A Staiger; Bryden J Stanley; Jonathan F McAnulty
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Publication Detail:
Type:  Journal Article     Date:  2011-09-14
Journal Detail:
Title:  Veterinary surgery : VS     Volume:  40     ISSN:  1532-950X     ISO Abbreviation:  Vet Surg     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2012-03-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8113214     Medline TA:  Vet Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  786-94     Citation Subset:  IM    
Copyright Information:
© Copyright 2011 by The American College of Veterinary Surgeons.
Affiliation:
Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI.
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