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Price et al: Evaluation of thoracic duct ligation and unilateral subphrenic pericardiectomy via a left fourth intercostal approach in normal canine cadavers
Veterinary Surgery 3, 2024

🔍 Key Findings

  • Left fourth intercostal thoracotomy allowed successful thoracic duct (TD) ligation in 9/10 canine cadavers.
  • 10/13 clinical cases had a single TD branch at the left fourth intercostal space, indicating lower anatomical complexity.
  • All TD branches at this site were lateral to the esophagus, simplifying surgical access.
  • Unilateral subphrenic pericardiectomy was successfully performed via the same incision in 10/10 cadavers.
  • Fewer TD branches at the fourth intercostal space than traditional caudal sites may reduce the risk of missed collaterals.
  • In contrast, traditional caudal TD ligation sites had up to 5 branches, requiring broader dissection.
  • No cadaver had right-sided TD branches, reducing surgical complexity at the studied location.
  • Contrast-confirmed ligation was effective in 90% (9/10) cadavers on CT imaging.

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← Articles

Price et al: Evaluation of thoracic duct ligation and unilateral subphrenic pericardiectomy via a left fourth intercostal approach in normal canine cadavers
Veterinary Surgery 3, 2024

🔍 Key Findings

  • Left fourth intercostal thoracotomy allowed successful thoracic duct (TD) ligation in 9/10 canine cadavers.
  • 10/13 clinical cases had a single TD branch at the left fourth intercostal space, indicating lower anatomical complexity.
  • All TD branches at this site were lateral to the esophagus, simplifying surgical access.
  • Unilateral subphrenic pericardiectomy was successfully performed via the same incision in 10/10 cadavers.
  • Fewer TD branches at the fourth intercostal space than traditional caudal sites may reduce the risk of missed collaterals.
  • In contrast, traditional caudal TD ligation sites had up to 5 branches, requiring broader dissection.
  • No cadaver had right-sided TD branches, reducing surgical complexity at the studied location.
  • Contrast-confirmed ligation was effective in 90% (9/10) cadavers on CT imaging.

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Multiple Choice Questions on this study

In Price 2024 et al., on left-sided TD ligation in dogs, where were all thoracic duct branches located in cadaveric dissections?

A. Right side of esophagus
B. Medial to aorta
C. Left side of esophagus
D. Lateral to trachea
E. Around the azygos vein

Answer: Left side of esophagus

Explanation: All TD branches in cadavers were lateral to the esophagus, simplifying access.
In Price 2024 et al., on left-sided TD ligation in dogs, what percentage of cadavers showed successful thoracic duct ligation at the fourth intercostal space?

A. 70%
B. 80%
C. 90%
D. 100%
E. 60%

Answer: 90%

Explanation: Ligation success was confirmed via CT in 9 out of 10 cadavers.
In Price 2024 et al., on left-sided TD ligation in dogs, what anatomical advantage was associated with the left fourth intercostal approach?

A. Higher duct pressure
B. Fewer thoracic duct branches
C. More accessible vasculature
D. Enhanced pericardial visualization
E. Better lymphatic drainage

Answer: Fewer thoracic duct branches

Explanation: This region had fewer branches than traditional sites, reducing collateral risk.
In Price 2024 et al., on left-sided TD ligation in dogs, how many clinical cases showed a single thoracic duct branch at the proposed surgical site?

A. 6 out of 13
B. 13 out of 13
C. 10 out of 13
D. 4 out of 13
E. 11 out of 13

Answer: 10 out of 13

Explanation: 10 of 13 clinical lymphangiograms showed a single branch at the fourth intercostal space.
In Price 2024 et al., on left-sided TD ligation in dogs, which procedure was successfully completed via the same incision as TD ligation?

A. Partial sternotomy
B. Subxiphoid window creation
C. Subphrenic pericardiectomy
D. En bloc lymphadenectomy
E. Diaphragmatic hernia repair

Answer: Subphrenic pericardiectomy

Explanation: All 10 cadavers had this procedure performed via the same left thoracotomy.

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