The Anatomy of the Thoracic Duct and Cisterna Chyli: A Meta-Analysis with Surgical Implications.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational anatomical studies
PubMed 39124550 · doi:10.3390/jcm13154285
What was done
A systematic review and meta-analysis across PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar to evaluate the topographical and morphometric characteristics of the thoracic duct (TD) and cisterna chyli (CC).
What was found
The thoracic duct terminated at the left venous angle with a pooled prevalence of 45.29% (95% CI: 25.51–65.81%). It terminated as a single vessel in 78.41% of cases (95% CI: 70.91–85.09%) and divided into two or more terminating branches in approximately a quarter of cases. The pooled prevalence of the cisterna chyli was 55.49% (95% CI: 26.79–82.53%).
Why it matters
Understanding the anatomical variations and termination patterns of the thoracic duct and cisterna chyli aids head, neck, and thoracic surgeons in minimizing accidental lymphatic duct injury.
Limits
The abstract does not report the total number of included studies, overall sample size, or subject demographics. The confidence intervals for left venous angle termination and cisterna chyli prevalence are very wide, indicating substantial heterogeneity across the underlying observational studies. Variations between cadaveric versus in vivo imaging cohorts are not described.