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临床健康猫胸导管结扎和乳糜池切除术后的腹部淋巴引流

Abdominal lymphatic drainage after thoracic duct ligation and cisterna chyli ablation in clinically normal cats.

作者信息

Dickerson Vanna M, Grimes Janet A, Secrest Scott A, Wallace Mandy L, Schmiedt Chad W

出版信息

Am J Vet Res. 2019 Sep;80(9):885-890. doi: 10.2460/ajvr.80.9.885.

Abstract

OBJECTIVE

To characterize abdominal lymphatic drainage in cats after thoracic duct ligation (TDL) and cisterna chyli ablation (CCA).

ANIMALS

7 purpose-bred research cats.

PROCEDURES

Baseline CT lymphangiography was performed. A popliteal lymph node was injected with iohexol, and images were acquired at 5-minute intervals for 15 minutes. Cats underwent TDL and CCA; methylene blue was used to aid in identifying lymphatic vessels. The CT lymphangiography was repeated immediately after and 30 days after surgery. All cats were euthanized and necropsied.

RESULTS

Results of baseline CT lymphangiography were unremarkable for all 7 cats. Only 5 cats completed the study. Leakage of contrast medium at the level of the cisterna chyli was seen on CT lymphangiography images obtained from all cats immediately after surgery. Evaluation of 30-day postoperative CT lymphangiography images revealed small branches entering the caudal vena cava in 2 cats, leakage of contrast medium into the caudal vena cava with no visible branches in 1 cat, and no contrast medium in the caudal vena cava in 2 cats. Contrast medium did not flow beyond the level of the cisterna chyli in any cat. Gross examination during necropsy revealed that all cats had small lymphatic vessels that appeared to connect to local vasculature identified in the region of the cisterna chyli.

CONCLUSIONS AND CLINICAL RELEVANCE

Abdominal lymphaticovenous anastomoses formed after TDL and CCA in cats. This would support use of these procedures for treatment of cats with idiopathic chylothorax, although additional studies with clinically affected cats are warranted.

摘要

目的

描述猫在胸导管结扎术(TDL)和乳糜池消融术(CCA)后的腹部淋巴引流情况。

动物

7只专门繁育的实验猫。

步骤

进行基线CT淋巴管造影。向一只腘淋巴结注射碘海醇,每隔5分钟采集图像,共采集15分钟。猫接受TDL和CCA;使用亚甲蓝辅助识别淋巴管。术后立即及术后30天重复进行CT淋巴管造影。所有猫均实施安乐死并进行尸检。

结果

所有7只猫的基线CT淋巴管造影结果均无异常。只有5只猫完成了研究。术后立即从所有猫获取的CT淋巴管造影图像显示乳糜池水平有造影剂渗漏。对术后30天的CT淋巴管造影图像评估发现,2只猫有小分支进入尾腔静脉,1只猫造影剂漏入尾腔静脉但无可见分支,2只猫尾腔静脉内无造影剂。任何猫的造影剂均未流经乳糜池水平。尸检时大体检查发现,所有猫均有小淋巴管,似乎与乳糜池区域识别出的局部脉管系统相连。

结论及临床意义

猫在TDL和CCA后形成腹部淋巴静脉吻合。这将支持使用这些手术治疗特发性乳糜胸猫,尽管有必要对临床患病猫进行更多研究。

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