Rachel Dickson, Antoine Adam, David Garcia Rubio, Filippo Cinti, Ameet Singh, Philipp Mayhew, J. Brad Case, Boel A. Fransson
{"title":"Outcome of video‐assisted thoracoscopic treatment of idiopathic chylothorax in 15 cats","authors":"Rachel Dickson, Antoine Adam, David Garcia Rubio, Filippo Cinti, Ameet Singh, Philipp Mayhew, J. Brad Case, Boel A. Fransson","doi":"10.1111/vsu.14098","DOIUrl":null,"url":null,"abstract":"ObjectiveTo evaluate the outcomes and complications of video‐assisted thoracoscopic (VATS) treatment of chylothorax in cats.Study designMulti‐institutional retrospective study.AnimalsFifteen client‐owned cats.MethodsThe medical records of cats undergoing thoracoscopic thoracic duct ligation (TDL) for treatment of idiopathic chylothorax were reviewed. Cats undergoing additional procedures including thoracoscopic pericardectomy and/or laparoscopic cisterna chyli ablation (CCA)_were included. Follow up was obtained through communication with the referring veterinarian or owner.ResultsAll cats underwent thoracoscopic TDL. Thirteen cats underwent simultaneous pericardectomy and two cats underwent laparoscopic CCA without pericardectomy. Conversion from a thoracoscopic to open approach was necessary in 2/15 (13%) of thoracic duct ligations and 1/11 (9%) of pericardectomies. The most common postoperative complication was persistent pleural effusion in five cats (33%). Four of 15 cats (27%) died or were euthanized prior to hospital discharge following surgery. Recurrence of effusion occurred in 1/7 (14%) of cats that sustained resolution of the effusion at the time of surgery with a median follow up of 8 months. The overall mortality attributed to chylothorax was 47%.ConclusionThoracoscopic treatment of idiopathic chylothorax resulted in a low incidence of intraoperative complications or conversion in the study population; however, mortality related to feline idiopathic chylothorax remained high.Clinical significanceWhile VATS treatment of idiopathic chylothorax is technically feasible, further consideration of the underlying pathology and current treatment algorithm is needed to improve outcomes as this remains a frustrating disease to treat in the feline population.","PeriodicalId":23667,"journal":{"name":"Veterinary Surgery","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Veterinary Surgery","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.1111/vsu.14098","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
引用次数: 0
Abstract
ObjectiveTo evaluate the outcomes and complications of video‐assisted thoracoscopic (VATS) treatment of chylothorax in cats.Study designMulti‐institutional retrospective study.AnimalsFifteen client‐owned cats.MethodsThe medical records of cats undergoing thoracoscopic thoracic duct ligation (TDL) for treatment of idiopathic chylothorax were reviewed. Cats undergoing additional procedures including thoracoscopic pericardectomy and/or laparoscopic cisterna chyli ablation (CCA)_were included. Follow up was obtained through communication with the referring veterinarian or owner.ResultsAll cats underwent thoracoscopic TDL. Thirteen cats underwent simultaneous pericardectomy and two cats underwent laparoscopic CCA without pericardectomy. Conversion from a thoracoscopic to open approach was necessary in 2/15 (13%) of thoracic duct ligations and 1/11 (9%) of pericardectomies. The most common postoperative complication was persistent pleural effusion in five cats (33%). Four of 15 cats (27%) died or were euthanized prior to hospital discharge following surgery. Recurrence of effusion occurred in 1/7 (14%) of cats that sustained resolution of the effusion at the time of surgery with a median follow up of 8 months. The overall mortality attributed to chylothorax was 47%.ConclusionThoracoscopic treatment of idiopathic chylothorax resulted in a low incidence of intraoperative complications or conversion in the study population; however, mortality related to feline idiopathic chylothorax remained high.Clinical significanceWhile VATS treatment of idiopathic chylothorax is technically feasible, further consideration of the underlying pathology and current treatment algorithm is needed to improve outcomes as this remains a frustrating disease to treat in the feline population.
期刊介绍:
Veterinary Surgery, the official publication of the American College of Veterinary Surgeons and European College of Veterinary Surgeons, is a source of up-to-date coverage of surgical and anesthetic management of animals, addressing significant problems in veterinary surgery with relevant case histories and observations.
It contains original, peer-reviewed articles that cover developments in veterinary surgery, and presents the most current review of the field, with timely articles on surgical techniques, diagnostic aims, care of infections, and advances in knowledge of metabolism as it affects the surgical patient. The journal places new developments in perspective, encompassing new concepts and peer commentary to help better understand and evaluate the surgical patient.