Eur J Anat, 24 (4): 311-321 (2020)

Anatomic variations of cervical part of thoracic duct: a systematic review

Ioannis Tsouknidas¹, Stefanos Giannopoulos², Nikolaos Tasis¹, Aikaterini Mastoropoulou³, Panagiotis Skandalakis¹, Dimitrios Schizas⁴, Dimitrios Filippou¹

¹Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece²Department of Surgery, 251 HAF & VA Hospital, Athens, Greece³Department of Pediatrics, 401 General Military Hospital of Athens, Athens, Greece⁴First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece

ABSTRACT The thoracic duct is the largest lymphatic chan-nel of the human body, and presents with great anatomical variation at its cervical segment. Injury of the thoracic duct can result in local or systemic severe complications. In order to identify the prev-alence of the anatomical variations of the terminal portion of the thoracic duct, this study was per-formed according to PRISMA guidelines. Τhe I-square was used to assess heterogeneity. Α wide search was conducted in PubMed/ Embase/ Medli-ne until September 2019.Out of 28 potentially relevant studies identified by literature search, 14 studies comprising 751 pa-tients were included in the final analysis. The pre-valence of thoracic duct ending with a single termi-nal duct was found at 63% (37%-85%) of the pa-tients. Left internal jugular vein, left subclavian vein, left jugulosubclavian angle, or another vein, was found to receive at least one terminal branch of the thoracic duct in 32% (18%-47%), 27% (13%-43%), 32% (16%-51%) and 7% (0%-19%) of the cases, respectively. Each time the thoracic duct drained into the left internal jugular vein, the left subclavian vein and the left jugulosubclavian an-gle, a single terminal branch pattern was observedin 58% (21%-92%), 49% (6%- 93%) and 76% (49-96%) of the cases respectively.

Keywords: Thoracic duct â?? Anatomic variations â?? Thoracic duct injury â?? Chylous leak prevention