Canine idiopathic chylothorax: Anatomic characterization of the pre- and postoperative thoracic duct using computed tomography lymphography
Canine idiopathic chylothorax: Anatomic characterization of the pre- and postoperative thoracic duct using computed tomography lymphography
复制标题
犬特发性乳糜胸：使用计算机断层淋巴成像技术对术前和术后胸导管进行解剖学表征
DOI：
10.1111/vru.12966
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发表时间：
2021
影响因子：
1.7
通讯作者：
Sasai K.
中科院分区：
文献类型：
--
作者：
Kanai H;Furuya M;Yoneji K;Hagiwara K;Nukaya A;Kondo M;Aso T;Fujii A;Sasai K.
手术治疗改善了犬特发性乳糜胸的预后，尽管手术后偶尔会复发。进一步了解这种复发的可能原因将有助于受影响患者的预后和治疗计划。在这项回顾性病例系列研究中，我们描述了一组手术证实的特发性乳糜胸犬的详细术前和术后计算机断层淋巴造影（CTLG）成像特征。在14只诊断为特发性乳糜胸的犬中，有12只进行了术前CTLG。10只犬右侧存在胸导管，1只犬左侧存在胸导管，1只犬双侧存在胸导管。所有14只犬均通过视频辅助胸腔镜手术接受心包切除术和胸导管结扎术（TDL）的联合治疗。术后一周，进行了术后CTLG，14只犬中有7只的胸导管明显。3只犬的胸导管路径未改变，这可能是由于遗漏导管所致。四只狗被确定为有旁路形成：斜管起源于结扎部位，并连接到另一侧的管道。我们的研究结果表明，术后复发的乳糜胸在狗的可能原因之一可能是“看不见或睡眠”的细管道，是塌陷，术前CTLG扫描不可见。在TDL引起淋巴流压力的变化后，这些细小的胸导管可以通过术后CTLG变得明显。
Surgical treatment has improved the prognosis of canine idiopathic chylothorax, although a recurrence of the disease occurs occasionally after the procedure. An improved understanding of possible causes for this recurrence would be helpful for prognosis and treatment planning in affected patients. In this retrospective case series study, we described the detailed pre‐ and postoperative computed tomographic lymphography (CTLG) imaging characteristics for a group of dogs with surgically confirmed idiopathic chylothorax. Preoperative CTLG was performed in 12 of 14 dogs diagnosed with idiopathic chylothorax. Thoracic ducts were present on the right side in 10 dogs, left side in one dog, and bilaterally in one dog. All the 14 dogs received a combination therapy of pericardiectomy and thoracic duct ligation (TDL) by video‐assisted thoracoscopic surgery. One week after surgery, a postoperative CTLG was performed, and the thoracic ducts were apparent in seven of 14 dogs. Three dogs had an unchanged course of the thoracic duct, which could have resulted from a missed duct. Four dogs were identified as having a bypass formation: the oblique duct originated at the ligation site and connected to the duct on the other side. Our findings indicated that one of the possible causes for postoperative recurrence of chylothorax in dogs could be “invisible or sleeping” fine ducts that are collapsed and not visible in preoperative CTLG scans. After TDL causes a change in the pressure of lymphatic flow, these fine thoracic ducts may become apparent using postoperative CTLG.