{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:44:47Z","timestamp":1792424687480,"version":"4.5.0"},"reference-count":26,"publisher":"American Veterinary Medical Association (AVMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2023,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>To document outcomes of thoracoscopic treatment of idiopathic chylothorax (IC) in dogs with and without constrictive pericardial physiology (CPP) and evaluate patterns of chyle flow redistribution after thoracic duct ligation (TDL).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>ANIMALS<\/jats:title>\n<jats:p>26 client-owned dogs.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>PROCEDURES<\/jats:title>\n<jats:p>In this prospective cohort study, echocardiography and cardiac catheterization were performed to document CPP in dogs with IC. Thoracoscopic TDL with pericardiectomy was performed if CPP was present (TDL\/P group). Dogs without evidence of CPP underwent thoracoscopic TDL alone (TDL group). Dogs underwent preoperative, immediate postoperative, and 3-month postoperative CT lymphangiography studies when possible. Perioperative morbidity, resolution and late recurrence rates, and long-term outcome were recorded.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>17 dogs underwent TDL, and 9 underwent TDL\/P. Twenty-five of 26 (96%) survived the perioperative period. One dog died from ventricular fibrillation during pericardiectomy. Resolution rates for TDL and TDL\/P were 94% and 88%, respectively (<jats:italic>P<\/jats:italic> = .55), with 1 late recurrence occurring in the TDL group in a median follow-up of 25 months (range, 4 to 60 months). On 3-month postoperative CT lymphangiography studies, ongoing chyle flow past the ligation site was demonstrated in 5 of 17 dogs, of which 1 dog developed recurrence at 13 months postoperatively. In 15 of 17 dogs, chylous redistribution after TDL was principally by retrograde flow to the lumbar lymphatic plexus.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CLINICAL RELEVANCE<\/jats:title>\n<jats:p>In dogs without evidence of CPP, TDL alone was associated with a very good prognosis for treatment of IC. In the absence of CPP, the additional benefit of pericardiectomy in the treatment of IC is questionable.<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/javma.22.08.0381","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T12:40:22Z","timestamp":1671799222000},"page":"696-704","source":"Crossref","is-referenced-by-count":16,"title":["Resolution, recurrence, and chyle redistribution after thoracic duct ligation with or without pericardiectomy in dogs with naturally occurring idiopathic chylothorax"],"prefix":"10.2460","volume":"261","author":[{"given":"Philipp D.","family":"Mayhew","sequence":"first","affiliation":[{"name":"Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid M.","family":"Balsa","sequence":"additional","affiliation":[{"name":"Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A.","family":"Stern","sequence":"additional","affiliation":[{"name":"Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric G.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carina","family":"Gonzales","sequence":"additional","affiliation":[{"name":"Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle A.","family":"Steffey","sequence":"additional","affiliation":[{"name":"Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Briana","family":"Hagen","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T. N.","family":"Culp","sequence":"additional","affiliation":[{"name":"Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Giuffrida","sequence":"additional","affiliation":[{"name":"Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"1","key":"ref1","series-title":"Vet Surg","first-page":"21","article-title":"Thoracoscopic thoracic duct ligation and pericardectomy for treatment of chylothorax in dogs","volume":"39","author":"Allman DA","year":"2010","unstructured":"Allman DA, Radlinsky MG, Ralph AG, Rawlings CA. Thoracoscopic thoracic duct ligation and pericardectomy for treatment of chylothorax in dogs. Vet Surg. 2010;39(1):21\u201327.20210940"},{"issue":"7","key":"ref2","series-title":"J Am Vet Med Assoc","first-page":"904","article-title":"Minimally invasive treatment of idiopathic chylothorax in dogs by thoracoscopic thoracic duct ligation and subphrenic pericardectomy: 6 cases (2007\u20132010)","volume":"241","author":"Mayhew PD","year":"2012","unstructured":"Mayhew PD, Culp WTN, Mayhew KN, Morgan ODE. Minimally invasive treatment of idiopathic chylothorax in dogs by thoracoscopic thoracic duct ligation and subphrenic pericardectomy: 6 cases (2007\u20132010). J Am Vet Med Assoc. 2012;241(7):904\u2013909.23013503"},{"issue":"S1","key":"ref3","series-title":"Vet Surg","first-page":"O112","article-title":"Long-term outcome of video-assisted thoracoscopic thoracic duct ligation and pericardectomy in dogs with chylothorax: a multi-institutional study of 39 cases","volume":"48","author":"Mayhew PD","year":"2019","unstructured":"Mayhew PD, Steffey MA, Fransson BA, et al. Long-term outcome of video-assisted thoracoscopic thoracic duct ligation and pericardectomy in dogs with chylothorax: a multi-institutional study of 39 cases. Vet Surg. 2019;48(S1):O112\u2013O120.30376180"},{"issue":"suppl 1","key":"ref4","series-title":"Vet Surg","first-page":"O102","article-title":"Efficacy of en bloc thoracic duct ligation in combination with pericardectomy by video-assisted thoracoscopic surgery for canine idiopathic chylothorax","volume":"49","author":"Kanai H","year":"2020","unstructured":"Kanai H, Furuya M, Hagiwara K, et al. Efficacy of en bloc thoracic duct ligation in combination with pericardectomy by video-assisted thoracoscopic surgery for canine idiopathic chylothorax. Vet Surg. 2020;49(suppl 1):O102\u2013O111.31880337"},{"issue":"5","key":"ref5","series-title":"Vet Surg","first-page":"519","article-title":"Cisterna chyli ablation with thoracic duct ligation for chylothorax: results in eight dogs","volume":"34","author":"Hayashi K","year":"2005","unstructured":"Hayashi K, Sicard G, Gellasch K, Frank JD, Hardie RJ, McAnulty JF. Cisterna chyli ablation with thoracic duct ligation for chylothorax: results in eight dogs. Vet Surg. 2005;34(5):519\u2013523.16266346"},{"issue":"5","key":"ref6","series-title":"J Am Anim Hosp Assoc","first-page":"312","article-title":"Chylothorax treated via thoracic duct ligation and omentalization","volume":"46","author":"Stewart K","year":"2010","unstructured":"Stewart K, Padgett S. Chylothorax treated via thoracic duct ligation and omentalization. J Am Anim Hosp Assoc. 2010;46(5):312\u2013317.20810551"},{"issue":"8","key":"ref7","series-title":"Vet Surg","first-page":"926","article-title":"Prospective comparison of cisterna chyli ablation to pericardectomy for treatment of spontaneously occurring idiopathic chylothorax in the dog","volume":"40","author":"McAnulty JF","year":"2011","unstructured":"McAnulty JF. Prospective comparison of cisterna chyli ablation to pericardectomy for treatment of spontaneously occurring idiopathic chylothorax in the dog. Vet Surg. 2011;40(8):926\u2013934.22091690"},{"issue":"2","key":"ref8","series-title":"Vet J","first-page":"234","article-title":"Pleural omentalisation with en bloc ligation of the thoracic duct and pericardiectomy for idiopathic chylothorax in nine dogs and four cats","volume":"188","author":"Bussadori R","year":"2011","unstructured":"Bussadori R, Provera A, Martano M, et al. Pleural omentalisation with en bloc ligation of the thoracic duct and pericardiectomy for idiopathic chylothorax in nine dogs and four cats. Vet J. 2011;188(2):234\u2013236.20561805"},{"key":"ref9","series-title":"Textbook of Clinical Hemodynamics.","first-page":"182","article-title":"Pericardial disease and restrictive myocardial diseases","author":"Ragosta M","year":"2018","unstructured":"Ragosta M. Pericardial disease and restrictive myocardial diseases. In: Ragosta M, ed. Textbook of Clinical Hemodynamics. 2nd ed. Elsevier; 2018:182\u2013215."},{"issue":"3","key":"ref10","series-title":"J Vet Intern Med","first-page":"307","article-title":"Thoracic duct ligation and pericardectomy for treatment of idiopathic chylothorax.","volume":"18","author":"Fossum TW","year":"2004","unstructured":"Fossum TW, Mertens MM, Miller MW, et al. Thoracic duct ligation and pericardectomy for treatment of idiopathic chylothorax. J Vet Intern Med. 2004;18(3):307\u2013310.15188816"},{"issue":"4","key":"ref11","series-title":"Am J Vet Res","first-page":"967","article-title":"Lymphangiographic evaluation of experimentally induced chylothorax after ligation of the cranial vena cava in dogs.","volume":"47","author":"Fossum TW","year":"1986","unstructured":"Fossum TW, Birchard SJ. Lymphangiographic evaluation of experimentally induced chylothorax after ligation of the cranial vena cava in dogs. Am J Vet Res. 1986;47(4):967\u2013971.3963604"},{"issue":"1","key":"ref12","series-title":"Vet Rec Case Rep","first-page":"e000750","article-title":"Suspected electrically induced ventricular fibrillation during thoracoscopic partial pericardectomy in two dogs.","volume":"7","author":"Studer N","year":"2019","unstructured":"Studer N, Vizca\u00edno Rev\u00e9s N, Rytz U, Iff I. Suspected electrically induced ventricular fibrillation during thoracoscopic partial pericardectomy in two dogs. Vet Rec Case Rep. 2019;7(1):e000750. doi:10.1136\/vetreccr-2018-000750"},{"key":"ref13","series-title":"Textbook of Canine and Feline Cardiology: Principles and Clinical Practice","first-page":"173","article-title":"Sisson. Cardiac catheterization and angiocardiography","author":"Thomas WP","year":"1999","unstructured":"Thomas WP. Sisson. Cardiac catheterization and angiocardiography. In: Fox PR, Sisson D, Moise NS, eds. Textbook of Canine and Feline Cardiology: Principles and Clinical Practice. 2nd ed. Saunders; 1999:173\u2013192."},{"issue":"3","key":"ref14","series-title":"Vet Surg","first-page":"361","article-title":"Computed tomographic lymphography of the thoracic duct by mesenteric lymph node injection.","volume":"38","author":"Johnson EG","year":"2009","unstructured":"Johnson EG, Wisner ER, Kyles A, Koehler C, Marks SL. Computed tomographic lymphography of the thoracic duct by mesenteric lymph node injection. Vet Surg. 2009;38(3):361\u2013367.19573100"},{"issue":"suppl 1","key":"ref15","series-title":"Vet Surg","first-page":"O118","article-title":"Thoracoscopic detection of thoracic ducts after ultrasound-guided intrahepatic injection of indocyanine green detected by near-infrared fluorescence and methylene blue in dogs.","volume":"51","author":"Korpita MF","year":"2022","unstructured":"Korpita MF, Mayhew PD, Steffey MA, et al. Thoracoscopic detection of thoracic ducts after ultrasound-guided intrahepatic injection of indocyanine green detected by near-infrared fluorescence and methylene blue in dogs. Vet Surg. 2022;51(suppl 1):O118\u2013O127. doi:10.1111\/vsu.1368234297410"},{"issue":"8","key":"ref16","series-title":"Vet Med (Praha)","first-page":"342","article-title":"Perirectal injection of imaging materials for computed tomographic lymphography and near infrared fluorescent thoracoscopy in cats.","volume":"64","author":"Kamijo K","year":"2019","unstructured":"Kamijo K, Kanai E, Oishi M, Ichihara N, Asari M, Yamada K. Perirectal injection of imaging materials for computed tomographic lymphography and near infrared fluorescent thoracoscopy in cats. Vet Med (Praha). 2019;64(8):342\u2013347."},{"issue":"2","key":"ref17","series-title":"Vet Surg","first-page":"267","article-title":"Use of direct near-infrared fluorescent lymphography for thoracoscopic thoracic duct identification in 15 dogs with chylothorax.","volume":"47","author":"Steffey MA","year":"2018","unstructured":"Steffey MA, Mayhew PD. Use of direct near-infrared fluorescent lymphography for thoracoscopic thoracic duct identification in 15 dogs with chylothorax. Vet Surg. 2018;47(2):267\u2013276.29105790"},{"issue":"8","key":"ref18","series-title":"Vet Surg","first-page":"961","article-title":"Thoracoscopic subphrenic pericardectomy using double-lumen endobronchial intubation for alternating one-lung ventilation.","volume":"38","author":"Mayhew KN","year":"2009","unstructured":"Mayhew KN, Mayhew PD, Sorrell-Raschi L, Brown DC. Thoracoscopic subphrenic pericardectomy using double-lumen endobronchial intubation for alternating one-lung ventilation. Vet Surg. 2009;38(8):961\u2013966.20017854"},{"issue":"1","key":"ref19","series-title":"Vet Surg","first-page":"146","article-title":"Epicardial exposure provided by a novel thoracoscopic pericardectomy technique compared to standard pericardial window.","volume":"47","author":"Barbur LA","year":"2018","unstructured":"Barbur LA, Rawlings CA, Radlinsky MG. Epicardial exposure provided by a novel thoracoscopic pericardectomy technique compared to standard pericardial window. Vet Surg. 2018;47(1):146\u2013152.29094362"},{"key":"ref20","series-title":"Vet Surg","first-page":"61","article-title":"A systematic review of criteria used to report complications in soft tissue and oncologic surgical clinical research studies in dogs and cats.","volume":"49","author":"Follette CM","year":"2020","unstructured":"Follette CM, Giuffrida MA, Balsa IM, et al. A systematic review of criteria used to report complications in soft tissue and oncologic surgical clinical research studies in dogs and cats. Vet Surg. 2020;49:61\u201369.31290167"},{"issue":"4","key":"ref21","series-title":"Vet Surg","first-page":"611","article-title":"The development of ventricular fibrillation as a complication of pericardiectomy in 16 dogs.","volume":"51","author":"Raleigh JS","year":"2022","unstructured":"Raleigh JS, Mayhew PD, Visser LC, et al. The development of ventricular fibrillation as a complication of pericardiectomy in 16 dogs. Vet Surg. 2022;51(4):611\u2013619.35257394"},{"issue":"9","key":"ref22","series-title":"J Am Soc Echocardiogr","first-page":"965","article-title":"American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography.","volume":"26","author":"Klein AL","year":"2013","unstructured":"Klein AL, Abbara S, Agler DA, et al. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2013;26(9):965\u20131012.e15. doi:10.1016\/j.echo.2013.06.023"},{"issue":"4","key":"ref23","series-title":"Vet Radiol Ultrasound","first-page":"429","article-title":"Canine idiopathic chylothorax: anatomic characterization of the pre- and postoperative thoracic duct using computed tomography lymphography.","volume":"62","author":"Kanai H","year":"2021","unstructured":"Kanai H, Furuya M, Yoneji K, et al. Canine idiopathic chylothorax: anatomic characterization of the pre- and postoperative thoracic duct using computed tomography lymphography. Vet Radiol Ultrasound. 2021;62(4):429\u2013436.33684240"},{"issue":"5","key":"ref24","series-title":"J Am Vet Med Assoc","first-page":"652","article-title":"Treatment of idiopathic chylothorax in dogs and cats.","volume":"212","author":"Birchard SJ","year":"1998","unstructured":"Birchard SJ, Smeak DD, McLoughlin MA. Treatment of idiopathic chylothorax in dogs and cats. J Am Vet Med Assoc. 1998;212(5):652\u2013657.9524635"},{"issue":"7","key":"ref25","series-title":"Am J Vet Res","first-page":"948","article-title":"Variations in the canine thoracic duct system and the effects of surgical occlusion demonstrated by rapid aqueous lymphography using an intestinal lymphatic trunk.","volume":"40","author":"Kagan KG","year":"1979","unstructured":"Kagan KG, Breznock EM. Variations in the canine thoracic duct system and the effects of surgical occlusion demonstrated by rapid aqueous lymphography using an intestinal lymphatic trunk. Am J Vet Res. 1979;40(7):948\u2013958.507497"},{"issue":"5","key":"ref26","series-title":"Vet Radiol Ultrasound","first-page":"391","article-title":"Comparison of radiographic and computed tomography lymphangiography for identification of the canine thoracic duct.","volume":"46","author":"Esterline ML","year":"2005","unstructured":"Esterline ML, Radlinsky MG, Biller DS, Mason DE, Roush JK, Cash WC. Comparison of radiographic and computed tomography lymphangiography for identification of the canine thoracic duct. Vet Radiol Ultrasound. 2005;46(5):391\u2013395.16250396"}],"container-title":["Journal of the American Veterinary Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/261\/5\/javma.22.08.0381.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/261\/5\/javma.22.08.0381.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/261\/5\/javma.22.08.0381.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T13:01:33Z","timestamp":1741352493000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/261\/5\/javma.22.08.0381.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,1]]},"references-count":26,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.2460\/javma.22.08.0381","relation":{},"ISSN":["0003-1488"],"issn-type":[{"value":"0003-1488","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5,1]]}}}