Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Kanagawa, Japan.
Present address: Division of Companion Animal Surgery, Veterinary Teaching Hospital, Faculty of Agriculture, Iwate University, Iwate, Japan.
J Vet Med Sci. 2022 Aug 1;84(8):1079-1083. doi: 10.1292/jvms.22-0043. Epub 2022 Jun 8.
This study aimed to evaluate the outcomes and complications of triple-combination surgery consisting of thoracic duct ligation (TDL), partial pericardiectomy (PPC), and cisterna chyli ablation (CCA) for the treatment of idiopathic chylothorax in dogs. Eleven privately owned dogs with idiopathic chylothorax underwent the triple-combination surgery: TDL and PPC were performed in left recumbency, followed by CCA in dorsal recumbency. Of the 11 dogs, seven were Shiba, two were Afghan hounds, and one each was Borzoi and mixed-breed. TDL and PPC required two intercostal thoracotomies in five dogs, whereas they were performed through a single intercostal incision in the other dogs. None of the dogs showed major intraoperative complications. The median operation time was 190 min (range, 151-234 min). Nine dogs showed no pleural effusion after surgery without medical management. Another dog showed the disappearance of chylous effusion, followed by the pleural accumulation of modified transudate. However, the residual one dog in whom chylothorax did not improve postoperatively died 4 months after the combination surgery. The mortality rate at the conclusion of this study was 9.1%. Although the triple-combination surgery with TDL, PPC, and CCA was complex and required a prolonged operation time, the success rate of resolving chylothorax in our study was comparable to that of open surgery as previously reported. Therefore, this study suggests that such triple-combination surgery can become one of the therapeutic options for the management of canine idiopathic chylothorax.
本研究旨在评估三联手术（胸导管结扎术（TDL）、部分心包切除术（PPC）和胸导管切除术（CCA））治疗犬特发性乳糜胸的疗效和并发症。11 只特发性乳糜胸的私人拥有犬接受了三联手术：TDL 和 PPC 在左侧卧位进行，然后在俯卧位进行 CCA。11 只犬中，7 只为柴犬，2 只为阿富汗猎犬，1 只为俄罗斯猎狼犬，1 只为杂种犬。5 只犬进行 TDL 和 PPC 需要两次经肋间开胸术，而其他犬只则通过一次经肋间切口进行。所有犬均无主要手术并发症。中位手术时间为 190 分钟（范围，151-234 分钟）。9 只犬术后无需药物治疗即可无胸腔积液。另一只犬乳糜性胸腔积液消失后，出现改良漏出液的胸腔积聚。然而，术后乳糜胸未改善的最后一只犬在三联手术后 4 个月死亡。本研究结束时的死亡率为 9.1%。尽管 TDL、PPC 和 CCA 的三联手术复杂且需要较长的手术时间，但本研究中解决乳糜胸的成功率与先前报道的开放性手术相当。因此，本研究表明，这种三联手术可以成为犬特发性乳糜胸治疗的选择之一。
