Video-assisted thoracoscopic pericardial fenestration for loculated or recurrent effusions

Détails

ID Serval
serval:BIB_1FACBF07B3EE
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Video-assisted thoracoscopic pericardial fenestration for loculated or recurrent effusions
Périodique
European Journal of Cardio-Thoracic Surgery
Auteur(s)
Geissbuhler  K., Leiser  A., Fuhrer  J., Ris  H. B.
ISSN
1010-7940 (Print)
Statut éditorial
Publié
Date de publication
10/1998
Volume
14
Numéro
4
Pages
403-8
Notes
Journal Article --- Old url value: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9845146 --- Old month value: Oct
Résumé
OBJECTIVE: The validity of video-assisted thoracoscopic pericardial fenestration was prospectively assessed for loculated effusions. effusions previously treated by percutaneous catheter manoeuvres and those with concurrent pleural diseases. METHODS: Inclusion criteria consisted of echocardiographically documented pericardial effusions requiring diagnosis or relief of symptoms and recurrent effusions after failed percutaneous drainage and balloon pericardiotomy. Pre-operative CT-scan was used to delineate additional pleural pathology and to determine the side of intervention. All patients were followed clinically and by echocardiographic examination 3 months post-operatively. RESULTS: Twenty-four patients underwent thoracoscopic pericardial fenestration with 11 patients (54%) being previously treated by percutaneous catheter drainage, balloon pericardiotomy or subxyphoidal fenestration. Pre-operative echocardiography revealed septation and loculation in 18 patients (72%). Additional pleural pathology was identified on CT scan in 12 patients (50%) and talc pleurodesis was performed in six patients, all suffering from malignant pleural effusion. The mean operation time was 45 min (range 30-60 min) with no complications being observed. All patients were followed 3 months post-operatively by clinical and echocardiographic examination; relief of symptoms was achieved in all patients but echocardiography showed a recurrence in one patient (4%). Another recurrence was found by echocardiography after a mean follow-up time of 33 months in the 12 patients suffering from a non-malignant pericardial effusion. No recurrence of pleural or pericardial effusion was observed in the subset of patients with talc pleurodesis. CONCLUSION: Video-assisted thoracoscopic pericardial fenestration is safe and effective for loculated pericardial effusions previously treated by percutaneous drainage manoeuvres and those with concomitant pleural disease.
Mots-clé
Adolescent Adult Aged Aged, 80 and over Catheterization Drainage Echocardiography *Endoscopy Female Follow-Up Studies Humans Male Middle Aged Pericardial Effusion/complications/radiography/*surgery/ultrasonography Pericardiectomy/*methods Pleural Effusion/complications/therapy Pleural Effusion, Malignant/complications/therapy Pleurodesis Prospective Studies Recurrence Reproducibility of Results Safety Talc/administration & dosage *Thoracoscopy Time Factors Tomography, X-Ray Computed Video Recording
Pubmed
Web of science
Open Access
Oui
Création de la notice
29/01/2008 13:00
Dernière modification de la notice
20/08/2019 12:55
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