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DOI: 10.1055/s-0038-1623714
Cisterna-chyli-Ablation bei drei Katzen mit idiopathischem Chylothorax
Cisterna chyli ablation in three cats with idiopathic chylothoraxPublication History
Eingegangen:
09 August 2012
Akzeptiert nach Revision:
12 December 2012
Publication Date:
07 January 2018 (online)
Zusammenfassung
Gegenstand und Ziel: Vorgestellt werden drei Katzen mit chronischem idiopathischem Chylothorax, die im Rahmen der chirurgischen Therapie einer Cisterna-chyli-Ablation unterzogen wurden. Material und Methoden: Beschrieben werden neben der klinischen Symptomatik, Diagnostik, Therapie und dem Krankheitsverlauf dreier Patienten mit idiopathischem Chylothorax die Technik der Cisterna-chyli-Ablation bei der Katze. Ergebnisse: Bei allen drei Patienten verlief die Zerstörung der Lendenzisterne ohne intraoder postoperative Komplikationen. Die Cisterna chyli lässt sich durch präoperative Gabe einer kleinen Menge eines fettreichen Nahrungsmittels oder intraoperativ durch Injektion von verdünntem Methylenblau in das Lymphgefäßsystem ohne Schwierigkeiten darstellen. Die Cisterna-chyli-Ablation wurde nach erfolgloser Ductus-thoracicus-Ligatur, als Zusatztherapie zur Ligatur des Ductus thoracicus und subtotalen Perikardektomie sowie als ausschließliche Therapie angewandt. Klinische Relevanz: Die Cisterna-chyli-Ablation kann bei der Katze ohne Komplikationen durchgeführt werden. Sie sollte bei erfolgloser vorangegangener Therapie oder als Kombinationstherapie mit anderen chirurgischen Verfahren zur Senkung der Rezidivgefahr in Erwägung gezogen werden.
Summary
Objective: Presentation of three cats with chronic, idiopathic chylothorax treated with ablation of the cisterna chyli as an additional or a sole surgical treatment. Material and methods: Results of clinical and diagnostic examination, therapy and course of disease in three cats as well as the surgical technique of ablation of the cisterna chyli in cats are described. Results: There were no intraoperative or postoperative complications regarding cisterna chyli ablation. Intraoperative visualization of the cisterna chyli is easily achieved by administering a small portion of a fatty aliment preoperatively or by injection of diluted methylene blue into the lymphatic system intraoperatively. Ablation of the cisterna chyli was performed following an unsuccessful ligation of the thoracic duct, in combination with the ligation of the thoracic duct and subtotal pericardectomy or as a single surgical treatment. Clinical relevance: Cisterna chyli ablation can be performed without complications in cats. This technique should be considered in cases of previously failed surgical therapy or as an adjunct therapy used with other surgical options to decrease the risk of recurrence.
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Literatur
- 1 Allman DA, Radlinsky MG, Ralph AG, Rawlings CA. Thoracoscopic thoracic duct ligation and thoracoscopic pericardiectomy for treatment of chylothorac in dogs. Vet Surg 2010; 39 (01) 21-27.
- 2 Birchard SJ, Smeak DD, Fossum TW. Results of thoracic duct ligation in dogs with chylothorax. J Am Vet Med Assoc 1988; 193 (01) 68-71.
- 3 Bliss SP, Bliss SK, Harvey HJ. Use of recombinant tissue-plasminogen activator in a dog with chylothorax secondary to catheter associated thrombosis of the cranial vena cava. J Am Anim Hosp Assoc 2002; 38 (05) 431-435.
- 4 Bussadori R, Provera A, Martano M, Morello E, Gonzalo-Orden JM, La Rosa G, Stefano N, Maria RS, Sara Z, Buracco P. Pleural omentalisation with en bloc ligation of the thoracic duct and pericardiectomy for idiopathic chylothorax in nine dogs and four cats. Vet J 2011; 188 (02) 234-236.
- 5 Cahalane AK, Flanders JA, Steffey MA, Rassnick KM. Use of vascular access ports with intrathoracic drains for the treatment of pleural effusion in three dogs. J Am Vet Med Assoc 2007; 230 (04) 527-531.
- 6 Duncan NM. Chylothorax in a kitten. J S Afr Vet Assoc 1991; 62 (02) 75.
- 7 Enwiller TM, Radlinsky MG, Mason DE, Mason DE, Roush JK. Popliteal and mesenteric lymph node injection with methylene blue for coloration of the thoracic duct in dogs. Vet Surg 2003; 32 (04) 359-364.
- 8 Forrester SD, Fossum TW, Rogers KS. Diagnosis and treatment of chylothorax associated with lymphoblastic lymphosarcoma in four cats. J Am Vet Med Assoc 1991; 198 (02) 291-294.
- 9 Fossum TW, Forrester SD, Swenson CL, Miller MW, Cohen ND, Boothe HW, Birchard SJ. Chylothorax in cats: 37 cases (1969–1989). J Am Vet Med Assoc 1991; 198 (04) 672-678.
- 10 Fossum TW, Mertens MM, Miller MW, Peacock JT, Saunders A, Gordon S, Pahl G, Makarski LA, Bahr A, Hobson PH. Thoracic duct ligation and pericardectomy for the treatment of idiopathic chylothorax. J Vet Intern Med 2004; 18: 307-310.
- 11 Fossum TW, Miller MW, Rogers KS, Bonagura JD, Meurs KM. Chylothorax associated with right-sided heart failure in five cats. J Am Vet Med Assoc 1994; 204 (01) 84-89.
- 12 Gould L. The medical management of idiopathic chylothorax in a domestic long-haired cat. Can Vet J 2004; 45 (01) 51-54.
- 13 Greenberg MJ, Weisse CW. Spontaneous resolution of iatrogenic chylothorax in a cat. J Am Vet Med Assoc 2005; 226 (10) 1667-1670.
- 14 Hayashi K, Sicard GK, Gellasch K, Frank JD, Hardie RJ, McAnulty JF. Cisterna chili ablation with thoracic duct ligation for chylothorax: results in eight dogs. Vet Surg 2005; 34 (05) 519-523.
- 15 Hayes G. Chylothorax and fibrosing pleuritis secondary to thyrotoxic cardiomyopathy. J Small Anim Pract 2005; 46 (04) 203-205.
- 16 Howard J, Arceneaux KA, Paugh-Partington B, Oliver J. Blastomycosis granuloma involving the cranial vena cava associated with chylothorax and cranial vena caval syndrome in a dog. J Am Anim Hosp Assoc 2000; 36 (02) 159-161.
- 17 Kerpsack SJ, McLoughlin MA, Birchard SJ, Smeak DD, Biller DS. Evaluation of mesenteric lymphangiography and thoracic duct ligation in cats with chylothorax: 19 cases. J Am Vet Med Assoc 1994; 205 (05) 711-715.
- 18 Kerpsack SL, Smeak DD, Birchard SJ. Progressive lymphangiectasis and recurrent chylothorax in a dog after thoracic duct ligation. J Am Vet Med Assoc 1995; 207 (08) 1059-1062.
- 19 Kopko SH. The use of Rutin in a cat with idiopathic chylothorax. Can Vet J 2005; 46 (08) 729-731.
- 20 Lafond E, Weirich WE, Salisbury SK. Omentalization of the thorax for treatment of idiopathic chylothorax with constrictive pleuritits in a cat. J Am Anim Hosp Assoc 2001; 38 (01) 74-78.
- 21 MacDonald NJ, Noble PJ, Burrow RD. Efficacy of en bloc ligation of the thoracic duct: descriptive study in 14 dogs. Vet Surg 2008; 37 (07) 696-701.
- 22 Martin RA, Richards DLS, Barber DL. Transdiaphragmatic approach to thoracic duct ligation in the cat. Vet Surg 1988; 17: 22-26.
- 23 McIane MJ, Buote NJ. Lung lobe torsion associated with chylothorax in a cat. J Feline Med Surg 2011; 13 (02) 135-138.
- 24 Monnet E. Pleura and pleural space. In: Textbook of Small Animal Surgery, Volume 1. 3rd edn.. Slatter D. ed. Philadelphia: Saunders; 2003: 387-405.
- 25 Myers NC, Engler SJ, Jakowski RM. Chylothorax and chylous ascites in a dog with mediastinal lymphangiosarcoma. J Am Anim Hosp Assoc 1996; 32 (03) 263-269.
- 26 Sicard GK, Waller KR, McAnulty JF. The effect of cisterna chyli ablation combined with thoracic duct ligation on abdominal lymphatic drainage. Vet Surg 2005; 34 (01) 64-71.
- 27 Singh A, Brisson BA. Chylothorax associated with thrombosis of the cranial vena cava. Can Vet J 2010; 51 (08) 847-852.
- 28 Smeak DD, Birchard SJ, McLoughlin MA, Lindsey MM, Holt DE, Caywood DD, Downs MO. Treatment of chronic pleural effusion with pleuroperitoneal shunts in dogs: 14 cases (1985–1999). J Am Vet Med Assoc 2001; 219 (11) 1590-1597.
- 29 Staiger BA, Stanley BJ, McAnulty JF. Single paracostal approach to thoracic duct and cisterna chyli: Experimental Study and Case Series. Vet Surg 2011; 40 (07) 786-794.
- 30 Stewart K, Padgett S. Chylothorax treated via thoracic duct ligation and omentalization. J Am Anim Hosp Assoc 2010; 46 (05) 312-317.
- 31 Suess RP, Flanders JA, Beck KA, Earnest-Koons K. Constrictive pleuritis in cats with idiopathic chylothorax: 10 cases (1983–1991). J Am Anim Hosp Assoc 1994; 30: 70-77.
- 32 Thompson MS, Cohn LA, Jordan RC. Use of Rutin for medical management of idiopathic chylothorax in four cats. J Am Vet Med Assoc 1999; 215 (03) 345-348.
- 33 Trumpa M, Stephan I, Baumgartner W, Nolte I. Restrictive cardiomyopathy with chylothorax in a cat: the pathogenesis. Dtsch Tierärztl Wochenschr 2004; 111 (11) 438-442.
- 34 Viehoff FW, Stokhof AA. En bloc ligation of the thoracic duct in twelve dogs with idiopathic chylothorax. Tijdschr Diergeneeskd 2003; 128 (09) 278-283.
- 35 Vollmerhaus B. Lymphatisches System. In: Nickel, Schummer, Seiferle, Lehrbuch der Anatomie der Haustiere, Band 3, Kreislaufsystem, Haut und Hautorgane, 2. Aufl. Hamburg: Parey; 1984: 276-450.
- 36 Willauer CC, Breznock EM. Pleurovenous shunting technique for treatment of chylothorax in three dogs. J Am Vet Med Assoc 1987; 191 (09) 1106-1109.
- 37 Williams JM, Niles JD. Use of omentum as a physiologic drain for the treatment of chylothorax in a dog. Vet Surg 1999; 28 (01) 61-65.