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Thoracoscopic Visualization and Ligation of the Thoracic Duct in Dogs
Author(s) -
Radlinsky Maryann G.,
Mason Diane E.,
Biller David S.,
Olsen Dennis
Publication year - 2002
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1053/jvet.2002.31062
Subject(s) - medicine , thoracic duct , thoracoscopy , chylothorax , ligation , thoracotomy , surgery , lymphatic system , pathology
Objective— To develop a technique for thoracoscopic visualization and ligation of the thoracic duct in dogs. Study design— In vivo experimental study. Animals— Five mature, healthy dogs. Methods— Dogs were normal based on physical examination, negative occult heartworm test, normal complete blood count and biochemical profile, and normal thoracic radiographs. The dogs were anesthetized, and a ventral midline laparotomy was performed for catheterization of a mesenteric lymphatic. Lymphangiography was performed to determine thoracic duct anatomy. Thoracoscopy was performed in the caudal, right hemithorax after single lung intubation or bronchial blockade. At least two 10‐mm clips were placed across the thoracic duct in each dog. Lymphangiography was repeated to assess duct ligation. If complete duct occlusion was not achieved, thoracoscopy was repeated for additional clip placement. After surgery the dogs were euthanatized, and necropsies were performed. Results— Lymphangiography showed that multiple branches of the thoracic duct were present in every dog; bilateral thoracic duct branches were most common. Thoracoscopic identification and ligation of the thoracic duct was successful in all five dogs. Two dogs required a second thoracoscopic procedure to completely occlude flow of contrast through the thoracic duct. Surgery time for thoracoscopy averaged 59 ± 9.6 minutes. Retroperitoneal contrast accumulation after thoracic duct ligation occurred in two dogs. One dog required bilateral pulmonary ventilation. Conclusion— Thoracoscopy can be used to visualize the thoracic duct for ligation in normal dogs. Clinical relevance— Thoracoscopic ligation of the thoracic duct may be a therapeutic option for management of chylothorax in dogs.