Thoracoscopic Visualization and Ligation of the Thoracic Duct in Dogs

Radlinsky, MaryAnn G.; Mason, Diane; Biller, David S.; Olsen, Dennis

doi:10.1053/jvet.2002.31062

Cited by 79 publications

(78 citation statements)

References 17 publications

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“…Recently, some surgeons have performed thoracic duct ligation using thoracoscopy [5]. Since our study showed that injection of a contrast medium into a popliteal lymph node successfully delineated the thoracic duct without surgical treatment, it is likely that popliteal lymphangiography combined with thoracoscopic thoracic duct ligation improves surgical outcome and speeds up postoperative recovery [14].…”

Section: Discussionmentioning

confidence: 82%

Determination of Optimal Dosage and Delay Time for Computed Tomographic Lymphography after Percutaneous Injection of Iohexol into Popliteal Lymph Nodes in Dogs

Chun

Cho

Cheon

et al. 2009

The Journal of Veterinary Medical Science

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ABSTRACT. The purposes of this study were to determine the optimal dose and delay time for lymphography by injection of Iohexol into popliteal lymph nodes and to assess images of computed tomography by the established protocol. Three different doses (30, 60 and 90 mgI/kg) of water-soluble iodinated contrast medium were injected into 15 popliteal lymph nodes of 10 adult beagles, and fluoroscopy was performed. Filling and duration of contrast media and the number of visible ducts from popliteal lymph nodes to the thoracic duct and its branches were recorded. CT lymphography was performed, and the number of visible thoracic ducts was compared with that found by radiographic lymphography. Radiographs obtained between 130 and 800 seconds after injection of contrast medium provided a detailed view of the thoracic duct. The dose of 60 mgI/kg was determined to enable quality diagnostic imaging without extranodal leakage in radiographic lymphography. There was no significant difference in the number of thoracic ducts between the two modalities at each anatomic location. However, CT lymphography provided images of the thoracic duct with better spatial resolution and without superimposition of surrounding tissue. The present study provides an adequate delay time and injection for identification of the canine thoracic duct, and therefore, this technique could be applied to diagnosis of disease associated with chest lymphatic drainage.KEY WORDS: CT, dog, Percutaneous ultrasound guided popliteal lymphograhy, thoracic duct.

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Section: Discussionmentioning

confidence: 82%

Determination of Optimal Dosage and Delay Time for Computed Tomographic Lymphography after Percutaneous Injection of Iohexol into Popliteal Lymph Nodes in Dogs

Chun

Cho

Cheon

et al. 2009

The Journal of Veterinary Medical Science

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“…Visualisation of the TD was obvious in five out of nine patients (those where 240 mg/ml iohexol was used at 37°C). Taken together, in cases where cannulation of an abdominal lymph vessel was used, the success rate with contrast media or with MB seems to be higher regardless of the animal species (Radlinsky et al 2002;Fossum et al 2004;Leasure et al 2011). However, since the catheterisation of an abdominal lymph vessel is a demanding procedure that requires an open approach to the abdominal cavity, our study aimed to evaluate alternative techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Thoracoscopic visualisation of the TD has been documented in dogs (Radlinsky et al 2002;Allman et al 2010;Leasure et al 2011) and in pigs (Ashitate et al 2011). Positioning the patient in sternal recumbency allows better access to the caudal mediastinal structures and to the tissues located from the dorsal to the aorta.…”

Section: Discussionmentioning

confidence: 99%

“…Because the observed resolution rates with conservative management are low, surgery is usually preferred. Current surgical management of chylothorax consists of the following: TD ligation (Fossum et al 1986;Fossum et al 1991); partial pericardiectomy with or without TD ligation (Fossum et al 2004;Carobbi et al 2008); clipping of the TD during thoracoscopy (Radlinsky et al 2002); clipping or sealing of the TD and pericardiectomy during thoracoscopy (Allman et al 2010;Haimel et al 2012); cisterna chyli ablation with or without TD ligation (Hayashi et al 2005;Sakals et al 2011); omentalisation with or without TD ligation (Williams and Niles 1999;Talavera et al 2009;Stewart and Padgett 2010); or pleurodesis (Radlinsky 2012).…”

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confidence: 99%

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Visualisation of the thoracic duct after popliteal lymph node injection in the pig: comparison of radiographic and thoracoscopic techniques

Vnuk¹,

Kurilj²,

Matičić³

et al. 2014

Vet. Med. - Czech

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Radiographic contrast studies have been recommended to identify the thoracic duct (TD) and its branches before and after surgery for total occlusion. The macroscopic identification of the TD and its branches during surgery usually involves injection of methylene blue (MB). Radiographic contrast and methylene blue can be injected into different anatomical structures (lymph node, lymph vessel, s.c.). The purpose of this study was to compare two different techniques (radiographic and thoracoscopic) for visualisation of the TD after intrapopliteal lymph node injection in the pig. Six piglets from the same litter (two males and four females), two months of age were used. Iohexol at 245 mg/ml was injected into the left popliteal lymph node (LN) under general anaesthesia; hindlimb, abdominal, and thoracic radiographs were taken. A 0.25% methylene blue solution was injected into the right popliteal lymph node and the thoracic duct colouration was assessed thoracoscopically. The thoracic duct was visualised radiographically in one out of six pigs after iohexol injection and thoracoscopically in five out of six pigs after methylene blue injection. The difference was statistically significant (P = 0.040). Popliteal LN lymphangiography using iohexol at 245 mg/ml in piglets should not be the recommended method for TD visualisation. Intrapopliteal injection of a 0.25% solution of methylene blue is recommended as a method of TD visualisation prior to thoracic duct ligation.

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“…Diagnostic evaluation of, and surgical procedures within, the thorax (thoracoscopy) are also commonly carried out in referral centres. The most frequently performed procedures are lung biopsy and pericardial resection, but thoracic duct ligation (TDL) (Radlinsky and others 2002), pulmonary lobectomy, mediastinal mass biopsy and removal, as well as a number of other techniques have also been reported and are practical in selected cases.…”

Section: Thoracoscopymentioning

confidence: 99%

Minimally invasive soft tissue surgery in dogs and cats

Moore¹

2010

In Practice

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Part 1 of this article, published in the October 2010 issue of In Practice (volume 32, pp 426–431), outlined the equipment required for minimally invasive soft tissue surgery in small animals and described its use for common abdominal procedures. This article discusses how similar techniques may be applied to the thorax, urethra and bladder. However, it is important to note that new applications are constantly being developed for this type of surgery, and it is likely that other body systems will benefit from further innovation in the future.

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Thoracoscopic Visualization and Ligation of the Thoracic Duct in Dogs

Abstract: Thoracoscopic ligation of the thoracic duct may be a therapeutic option for management of chylothorax in dogs.

Cited by 79 publications

References 17 publications

Determination of Optimal Dosage and Delay Time for Computed Tomographic Lymphography after Percutaneous Injection of Iohexol into Popliteal Lymph Nodes in Dogs

Determination of Optimal Dosage and Delay Time for Computed Tomographic Lymphography after Percutaneous Injection of Iohexol into Popliteal Lymph Nodes in Dogs

Visualisation of the thoracic duct after popliteal lymph node injection in the pig: comparison of radiographic and thoracoscopic techniques

Minimally invasive soft tissue surgery in dogs and cats

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