Pleural omentalisation with en bloc ligation of the thoracic duct and pericardiectomy for idiopathic chylothorax in nine dogs and four cats

Bussadori, R.; Provera, Alessandra; Martano, Marina; Morello, Emanuela; Orden, José Manuel Gonzalo; Rosa, Giuseppe La; Nicoli, Stefano; Maria, Repetto Silvia; Zabarino, Sara; Buracco, Paolo

doi:10.1016/j.tvjl.2010.05.010

Cited by 32 publications

(30 citation statements)

References 6 publications

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“…The omentum has a number of unique physiological properties including promoting angiogenesis, enhancement of inflammatory functions, macrophage margination, immune function and fibroplasia that have been exploited in small animal surgery (Hosgood 1990, White 2000, Hoelzler and others 2001, Johnson and Mann 2006, McAlinden and others 2009, Stewart and Paggett 2010, DaSilva and others 2011, Bussadori and others 2011, Franklin and others 2011). In particular, its ability to contain, resolve and wall off sites of abscessation has proved useful in the management of abscesses in the mediastinum (Franklin and others 2011), pancreas (Johnson and Mann 2006) and prostate gland (White 2000).…”

Section: Discussionmentioning

confidence: 99%

Omentalisation in the treatment of sublumbar abscessation: long‐term outcome in 10 dogs

Woodbridge

Martinoli²,

Cherubini

et al. 2014

Veterinary Record

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The objectives of this study were to report the technique of omentalisation for the management of sublumbar abscessation associated with suspected migrating plant material, the intraoperative and postoperative complications that occurred and the long-term outcome of the cases. A retrospective case series of dogs (n=10) with sublumbar abscessation managed by exploration and drainage combined with omentalisation of the abscess cavity is reported in this study. The sublumbar area was approached through a ventral midline coeliotomy, the abscess was explored, drained, debrided and subsequently packed with omentum. One dog sustained an aortic rupture during exploration of the abscess, the aorta was repaired; there were no postoperative complications. There was long-term (>12 months) resolution of clinical signs in all dogs. Drainage and omentalisation of sublumbar abscesses resulted in complete resolution of signs in all dogs and was associated with a low incidence of complications. Omentalisation is an effective treatment for dogs presenting with sublumbar abscesses associated with suspected migrating plant material.

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Section: Discussionmentioning

confidence: 99%

Omentalisation in the treatment of sublumbar abscessation: long‐term outcome in 10 dogs

Woodbridge

Martinoli²,

Cherubini

et al. 2014

Veterinary Record

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“…; Bussadori et al . ). However, there are reports of pleural space infection in animals with chylothorax.…”

Section: Discussionmentioning

confidence: 97%

“…In this study, idiopathic chylothorax was the risk factor most significantly associated with postoperative pyothorax in the multivariable analysis. This result was unexpected as multiple case series reporting surgical management of chylothorax do not site this as a significant complication (Birchard et al 1988;Fossum et al 2004;Hayashi et al 2005;Carobbi et al 2008;Allman et al 2010;Bussadori et al 2011). However, there are reports of pleural space infection in animals with chylothorax.…”

Section: Dogs With Postoperative Pyothoraxmentioning

confidence: 97%

Prevalence, outcome and risk factors for postoperative pyothorax in 232 dogs undergoing thoracic surgery

Meakin

Salonen

Brockman

et al. 2013

J of Small Animal Practice

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ObjectiveTo determine the prevalence, outcome and risk factors for postoperative pyothorax in dogs undergoing thoracic surgery.MethodsCase records were reviewed retrospectively to identify dogs with post thoracic surgery pyothorax, defined as septic neutrophilic inflammation within the pleural space based on cytology and/or a positive bacterial culture of pleural fluid. Those identified were reviewed for potential risk factors for postoperative pyothorax based on biological plausibility and previously published data. These potential risk factors were explored by multivariable logistic regression.ResultsOf 232 dogs undergoing thoracic surgery, 15 (6·5%) dogs developed pyothorax. Bacteria cultured included methicillin-resistant Staphylococcus aureus and multi-resistant Escherichia coli. Of these dogs, six died, four were euthanased and five were treated successfully. A diagnosis of idiopathic chylothorax [Odds Ratio (OR)=12·5, 95% Confidence Interval (CI)=2·7-58·5, P=0·001], preoperative intrathoracic biopsy (OR=14·3, 95% CI=1·7-118·7, P=0·014) and preoperative thoracocentesis (OR=11·2, 95% CI=1·6-78·2, P=0·015) were identified as independent risk factors for development of postoperative pyothorax.Clinical SignificanceIdiopathic chylothorax, intrathoracic biopsy and prior thoracocentesis are independent risk factors for postoperative pyothorax, which was associated with a 67% mortality rate.

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“…47 It should be noted that identification of the thoracic duct branches is extremely challenging in cats and in the aforementioned study the authors suggested their high success rate could be attributed to surgeon experience and the use of magnification techniques. Although it has not been assessed in many cats, pleural omentalization does not seem to improve success rates and is not necessarily recommended at initial surgery, 49,50 the reason being that the omental lymphatic vessels ultimately drain into the chysterna chyli and thoracic duct so this procedure may have little impact on the volume of fluid produced. 47 For those cases where thoracic duct ligation has failed, repeat thoracotomy to attempt further ligation may be of benefit.…”

Section: Thoracic Duct Ligationmentioning

confidence: 99%

Pleura

Moores¹

2014

Feline Soft Tissue and General Surgery

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Pleural omentalisation with en bloc ligation of the thoracic duct and pericardiectomy for idiopathic chylothorax in nine dogs and four cats

Cited by 32 publications

References 6 publications

Omentalisation in the treatment of sublumbar abscessation: long‐term outcome in 10 dogs

Omentalisation in the treatment of sublumbar abscessation: long‐term outcome in 10 dogs

Prevalence, outcome and risk factors for postoperative pyothorax in 232 dogs undergoing thoracic surgery

Pleura

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