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Dickson et al: Outcome of video-assisted thoracoscopic treatment of idiopathic chylothorax in 15 cats
Veterinary Surgery 5, 2024

🔍 Key Findings

  • Objective: To evaluate outcomes and complications of video-assisted thoracoscopic surgery (VATS) for idiopathic chylothorax in 15 cats.
  • All 15 cats underwent thoracoscopic thoracic duct ligation (TDL); 13 also had simultaneous pericardectomy, 2 had VATS TDL + laparoscopic cisterna chyli ablation (CCA), and 1 cat had an open CCA.
  • Median surgical time was 152.5 minutes (range 60–255).
  • Contrast was used intraoperatively in 13 cats; 11 received methylene blue, and 2 received indocyanine green (ICG).
  • One intraoperative complication (6%) occurred — a minor intercostal artery laceration. Conversion to open surgery occurred in 3 cases (20%) due to visualization issues or bleeding.
  • Postoperative complications occurred in 8 cats (53%), with persistent pleural effusion in 5 cats (33%) being the most common.
  • Mortality was high: 4 cats (27%) died or were euthanized before discharge. Only 7 of 11 cats discharged had resolution of effusion, and recurrence occurred in 1.
  • Authors concluded that while VATS is technically feasible in cats, it did not improve clinical outcomes compared to open surgery, and feline idiopathic chylothorax continues to have a high mortality rate.

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← Articles

Dickson et al: Outcome of video-assisted thoracoscopic treatment of idiopathic chylothorax in 15 cats
Veterinary Surgery 5, 2024

🔍 Key Findings

  • Objective: To evaluate outcomes and complications of video-assisted thoracoscopic surgery (VATS) for idiopathic chylothorax in 15 cats.
  • All 15 cats underwent thoracoscopic thoracic duct ligation (TDL); 13 also had simultaneous pericardectomy, 2 had VATS TDL + laparoscopic cisterna chyli ablation (CCA), and 1 cat had an open CCA.
  • Median surgical time was 152.5 minutes (range 60–255).
  • Contrast was used intraoperatively in 13 cats; 11 received methylene blue, and 2 received indocyanine green (ICG).
  • One intraoperative complication (6%) occurred — a minor intercostal artery laceration. Conversion to open surgery occurred in 3 cases (20%) due to visualization issues or bleeding.
  • Postoperative complications occurred in 8 cats (53%), with persistent pleural effusion in 5 cats (33%) being the most common.
  • Mortality was high: 4 cats (27%) died or were euthanized before discharge. Only 7 of 11 cats discharged had resolution of effusion, and recurrence occurred in 1.
  • Authors concluded that while VATS is technically feasible in cats, it did not improve clinical outcomes compared to open surgery, and feline idiopathic chylothorax continues to have a high mortality rate.

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Multiple Choice Questions on this study

In Dickson 2024 et al., on VATS for feline chylothorax, what was the study's overall conclusion about clinical outcomes?

A. It significantly reduced recurrence
B. It improved short-term outcomes
C. It was more effective than open surgery
D. It was technically feasible but did not improve outcomes
E. It eliminated the need for pleural drainage

Answer: It was technically feasible but did not improve outcomes

Explanation: VATS was feasible in cats, but mortality remained high and outcomes were not superior to open surgery.
In Dickson 2024 et al., on VATS for feline chylothorax, what percentage of cats required conversion to open surgery?

A. 0%
B. 7%
C. 13%
D. 20%
E. 27%

Answer: 20%

Explanation: Conversion was required in 3 of 15 cases (20%) due to bleeding or poor visualization.
In Dickson 2024 et al., on VATS for feline chylothorax, what was the most common postoperative complication?

A. Pneumothorax
B. Hemothorax
C. Seroma
D. Persistent pleural effusion
E. Arrhythmia

Answer: Persistent pleural effusion

Explanation: 5 of 15 cats developed persistent pleural effusion, the most frequent complication.
In Dickson 2024 et al., on VATS for feline chylothorax, which agents were used to visualize the thoracic duct?

A. Barium and iodine
B. Methylene blue and ICG
C. Furosemide and saline
D. Methylene blue and mannitol
E. ICG and fluorescein

Answer: Methylene blue and ICG

Explanation: Methylene blue (11 cats) and ICG (2 cats) were used for duct visualization.
In Dickson 2024 et al., on VATS for feline chylothorax, what was the survival rate to hospital discharge?

A. 27%
B. 40%
C. 60%
D. 73%
E. 100%

Answer: 73%

Explanation: 11 of 15 cats survived to hospital discharge, equating to a 73% discharge rate.

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