{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T05:50:38Z","timestamp":1788587438728,"version":"build-2803163510"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T00:00:00Z","timestamp":1733270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Vet. Sci."],"abstract":"<jats:p>Open surgical treatment of idiopathic chylothorax via thoracic duct ligation and pericardiectomy requires a lengthy procedure with two thoracotomy incisions. The objectives of this report were to describe an approach for thoracic duct ligation and pericardiectomy via a single thoracotomy at the left fourth intercostal space and to describe the clinical outcome in two dogs with idiopathic chylothorax. Dogs were prospectively enrolled in a pilot study to evaluate the clinical efficacy of thoracic duct ligation at the left fourth intercostal space, combined with subphrenic pericardiectomy performed through the same incision. Dogs had a preoperative CT lymphangiogram to evaluate the anatomy of the thoracic duct and its branching pattern prior to surgery. Recheck radiographs were performed every 2\u20134\u202fweeks until effusion resolved. Pleural effusion became non-chylous by 5\u202fdays postoperatively. Pleural effusion volume decreased by day 5 postoperatively, allowing removal of thoracostomy tube and discharge from the hospital. Radiographically, effusion resolved within 6\u202fweeks without a need for further drainage after discharge. Dogs remained symptom-free at last follow up (&amp;gt;11\u202fmonths postoperatively). CT lymphangiograms were repeated &amp;gt;11\u202fmonths postoperatively and revealed no recurrence of pleural effusion. No intraoperative or postoperative complications directly related to surgery were noted for either dog. Collateral lymphatic vessels were not identified on recheck CT lymphangiograms. The left fourth intercostal approach to thoracic duct ligation and pericardiectomy has potential to be a safe and effective alternative to an open approach requiring two lateral thoracotomies. Further investigation of this approach using open or minimally invasive techniques is warranted.<\/jats:p>","DOI":"10.3389\/fvets.2024.1463939","type":"journal-article","created":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T06:46:37Z","timestamp":1733294797000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["A single left fourth intercostal thoracotomy approach for resolution of idiopathic chylothorax with thoracic duct ligation and pericardiectomy: a preliminary clinical study in two dogs"],"prefix":"10.3389","volume":"11","author":[{"given":"Anya K.","family":"Price","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle G.","family":"Mathews","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,12,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1111\/j.1939-1676.2004.tb02550.x","article-title":"Thoracic duct ligation and pericardectomy for treatment of idiopathic chylothorax","volume":"18","author":"Fossum","year":"2004","journal-title":"J Vet Intern Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1136\/vr.163.25.743","article-title":"Treatment of idiopathic chylothorax in 14 dogs by ligation of the thoracic duct and partial pericardiectomy","volume":"2008","author":"Carobbi","year":"2008","journal-title":"Vet Rec"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1111\/vsu.13322","article-title":"Treatment of idiopathic chylothorax in dogs and cats: a systematic 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subcutaneous contrast agent injection in a dog with chylothorax","volume":"6","author":"Iwanaga","year":"2016","journal-title":"Open Vet J"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1111\/ahe.12745","article-title":"Anatomical variations of the thoracic duct in the dog","volume":"50","author":"Korpes","year":"2021","journal-title":"Anat Histol Embryol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1111\/vsu.14060","article-title":"Evaluation of thoracic duct ligation and unilateral subphrenic pericardiectomy via a left fourth intercostal approach in normal canine cadavers","volume":"53","author":"Price","year":"2024","journal-title":"Vet Surg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1111\/j.1532-950X.2008.00473.x","article-title":"Computed tomographic lymphography of the thoracic duct by mesenteric lymph node injection","volume":"38","author":"Johnson","year":"2009","journal-title":"Vet 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