Original Article
Pericardial-peritoneal window for malignant pericardial effusion
Abstract
Background: Malignant pericardial effusion is a pathological accumulation of fluid in the pericardial cavity occurring in patients with different types of cancer. The condition can be life-threatening not only in patients with terminal malignancies but also in those with a more favorable prognosis. The creation of a pericardial-peritoneal window is a surgical procedure connecting the pericardium with the peritoneal cavity and the definitive treatment of pericardial effusion.
Methods: Twenty consecutive patients with malignant pleural effusion undergoing pericardial-peritoneal window from 2006 to 2017 were enrolled in the present study. Data were collected on sex, age, preoperative ultrasound and computed tomography findings, histology and pathological stage of the neoplasm, intraoperative findings and additional surgical procedures needed. Further information included total postoperative complications, 30-day mortality rate, pulmonary and cardiac complications, ICU admission and hospital stay, median overall survival (OS).
Results: Eleven patients were male and nine were females; median age was 63 years; 14 patients had lung cancer, 3 breast carcinomas, 1 ovarian adenocarcinoma, 1 renal cell carcinoma and 1 malignant mesothelioma. Intraoperative mean volume of the drained pericardial effusion was 500 mL; mean duration of the procedure was 73 minutes; postoperative mean length of stay was four days; five patients had postoperative complications; one patient died within 30 days. OS after 34 months of follow-up was 80.8%.
Conclusions: Pericardial-peritoneal window is a safe and effective procedure to resolve malignant pericardial effusion in patients with a favorable short-term prognosis, whereas pericardial drainage should be considered the most appropriate treatment in patients with a less favorable prognosis.
Methods: Twenty consecutive patients with malignant pleural effusion undergoing pericardial-peritoneal window from 2006 to 2017 were enrolled in the present study. Data were collected on sex, age, preoperative ultrasound and computed tomography findings, histology and pathological stage of the neoplasm, intraoperative findings and additional surgical procedures needed. Further information included total postoperative complications, 30-day mortality rate, pulmonary and cardiac complications, ICU admission and hospital stay, median overall survival (OS).
Results: Eleven patients were male and nine were females; median age was 63 years; 14 patients had lung cancer, 3 breast carcinomas, 1 ovarian adenocarcinoma, 1 renal cell carcinoma and 1 malignant mesothelioma. Intraoperative mean volume of the drained pericardial effusion was 500 mL; mean duration of the procedure was 73 minutes; postoperative mean length of stay was four days; five patients had postoperative complications; one patient died within 30 days. OS after 34 months of follow-up was 80.8%.
Conclusions: Pericardial-peritoneal window is a safe and effective procedure to resolve malignant pericardial effusion in patients with a favorable short-term prognosis, whereas pericardial drainage should be considered the most appropriate treatment in patients with a less favorable prognosis.
