Review of thoracic duct anatomical variations and clinical implications.
Level 4 - case-series / case-control
Systematic review of observational, cadaveric, surgical, and radiological anatomical studies
PubMed 24302465 · doi:10.1002/ca.22337
What was done
A systematic review was conducted across Google Scholar, MEDLINE, PubMed, and Scopus databases up to March 31, 2013, including English and non-English surgical, cadaveric, and radiological studies assessing anatomical variations of the thoracic duct.
What was found
A total of 57 articles published over 102 years were identified. Significant anatomical variability was observed in thoracic duct formation at the cisterna chyli, course through the thorax, and venous termination. The reported sites of venous termination were the internal jugular vein (46%), the jugulosubclavian angle (32%), and the subclavian vein (18%).
Why it matters
Detailed mapping of thoracic duct anatomical variations aids surgeons in preventing inadvertent iatrogenic injury and informs procedural feasibility for duct cannulation and lymph diversion in critical illness.
Limits
The abstract aggregates heterogeneous data across 102 years without reporting total patient or cadaver sample sizes, risk of bias assessments, or statistical measures of dispersion and heterogeneity.
Cited by
- supports The lymphatic ducts empty collected lymph into the vascular system immediately below the clavicles.