Long‐term outcome of video‐assisted thoracoscopic thoracic duct ligation and pericardectomy in dogs with chylothorax: A multi‐institutional study of 39 cases

Objective To evaluate the long‐term outcome of video‐assisted thoracoscopic (VATS) thoracic duct ligation (TDL) and pericardectomy for treatment of chylothorax in dogs. Study design Multi‐institutional retrospective study. Animals Thirty‐nine client‐owned dogs. Methods Dogs were included if they had undergone a VATS TDL and pericardectomy and had at least 1‐year follow‐up or had died within 1 postoperative year. Medical records were evaluated, and recorded data included clinicopathological and diagnostic imaging results, surgical findings, complications, conversion rates, and long‐term resolution and recurrence rates. Results Thirty‐nine dogs met the inclusion criteria. Two dogs died intraoperatively; 1 was euthanized after severe restrictive pleuritis was diagnosed intraoperatively, and 1 underwent ventricular fibrillation and cardiac arrest during pericardectomy and could not be resuscitated. Conversion to an open approach was required in 1 of 39 (3%) dogs for TDL and 4 of 36 (11%) dogs for pericardectomy. Overall follow‐up time was median 38 months (range, 3‐115). Resolution of pleural effusion occurred in 35 of 37 (95%) dogs that survived the perioperative period. Late recurrence of pleural effusion was seen at 12, 12, and 19 months postoperatively in 3 of 35 (9%) dogs that survived the perioperative period and in which chylothorax had initially resolved. Conclusion Successful long‐term resolution of chylothorax was seen in a high proportion of dogs that underwent VATS TDL and pericardectomy, although late recurrence was sometimes seen. Clinical significance Video‐assisted thoracoscopic thoracic duct ligation and pericardectomy are highly successful in dogs with chylothorax. Future studies should evaluate whether pericardectomy is required in dogs without evidence of pericardial disease.