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.