title: Minimally invasive treatment of idiopathic chylothorax in dogs by thoracoscopic thoracic duct ligation and subphrenic pericardiectomy: 6 cases (2007-2010).
abstract: OBJECTIVE
  To describe a technique and evaluate the outcome of thoracoscopic thoracic duct ligation (TDL) and subphrenic pericardiectomy (SPP) for treatment of idiopathic chylothorax (IC) in dogs.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  6 client-owned dogs.
  
  
  METHODS
  Medical records of dogs with a diagnosis of IC that were subsequently treated by thoracoscopic TDL and SPP and that had not undergone previous surgical treatment were reviewed. Thoracoscopic TDL was performed via a 3-portal technique with the patient in lateral recumbency. Subphrenic pericardiectomy was subsequently performed via a 3-portal technique with the patient in dorsal recumbency. If visualization during SPP was suboptimal, 1-lung ventilation was used to ensure that pericardial resection was close to the phrenic nerves bilaterally but without risk of iatrogenic nerve injury.
  
  
  RESULTS
  All TDL and SPP procedures were completed successfully in a median surgical time of 177 minutes (range, 135 to 210 minutes). All 6 dogs showed resolution of clinical signs of chylothorax with no recurrence during a median follow-up period of 39 months (range, 19 to 60 months). Final postoperative thoracic radiographic evaluation was performed at a median of 14.5 months (range, 7 to 25 months). Complete resolution of pleural effusion occurred in all but 1 dog. In 1 dog, a small volume of pleural effusion was persistent at a 7-month postoperative radiographic follow-up but was not associated with clinical signs and did not require thoracocentesis at any time during the dog's 25-month follow-up period.
  
  
  CONCLUSIONS
  From this limited series of patients, results suggested that a minimally invasive TDL-SPP combined surgical technique for management of IC in dogs may be associated with a similarly successful outcome as has been reported for open surgical TDL-SPP.
authors.affiliation: Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, 95616, USA. philmayhew@gmail.com
authors.forename: Philipp D
authors.initials: PD
authors.lastname: Mayhew
authors.forename: William T N
authors.initials: WT
authors.lastname: Culp
authors.forename: Kelli N
authors.initials: KN
authors.lastname: Mayhew
authors.forename: Oliver D E
authors.initials: OD
authors.lastname: Morgan
mesh_terms: D000818:Animals; D002916:Chylothorax / Q000601:surgery / Q000662:veterinary*; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D005260:Female; D008026:Ligation / Q000662:veterinary; D008297:Male; D010492:Pericardiectomy / Q000379:methods / Q000662:veterinary*; D012189:Retrospective Studies; D013897:Thoracic Duct / Q000601:surgery*