The efficacy of VATS, subxiphoid and minithoracotomy pericardial window for surgical management of symptomatic pericardial effusions

• Main Authors: Sezai Çelik, Bülent Aydemir, Oya Uncu, Tamer Okay, Muharrem Çelik
• Format: Article
• Language: English
• Published: Dicle University Medical School 2014-03-01
• Series: Dicle Medical Journal
• Subjects: pericardial effusion; VATS; subxiphoid; minithoracotomy
• Online Access: http://www.diclemedj.org/upload/sayi/31/Dicle%20Med%20J-01899.pdf
• ISSN: 1300-2945; 1300-2945

Objective: Pericardial effusion potentially cause significant morbidity and mortality. Pericardial window by video-assisted thoracic surgery (VATS), subxiphoid and minithoracotomy is available surgical treatment options. The aim of this study is to determine the efficacy and outcome of the three different methods for surgical management of symptomatic pericardial effusions. Methods: A retrospective study of patients operated for pericardial effusion between October 2007 to December 2011 at Dr. Siyami Ersek Hospital were divided into three groups according to surgical treatment d: Group 1 (VATS, n=24), Group 2 (Subxiphoid, n=28) Group 3 (Minithoracotomy, n=36). The groups were analyzed and compared using demographic information, operative and postoperative details and course, recurrence, follow-up data, morbidity, mortality and survival. Results: A total of 88 patients (37 women, 51 men, with mean age 54.47±16.81) underwent pericardial window were included in the study. The groups had similar perioperative characteristics except sex distribution and etiology. VATS, Subxiphoid and minithoracotomy pericardial window were well tolerated by patients, resulted in similar rates of mortality, 30-day mortality, overall postoperative complications, recurrence rates and survival. Operative time was significantly shorter in group 3 (p<0.01). Drained volume at operation and diagnostic value of pericardial biopsy significantly higher in group 3 (p<0.05, p<0.05). Patients undergoing Group 1 had a lower length of chest tube stay, intensive care unit stay and hospital stay but they did not reach to statistical significance (p>0.05). Group 2 had a significantly higher lenght of hospital stay (p<0.05). Conclusion: Minithoracotomy pericardial window provides rapid and definitive diagnosis and treatment for pericardial effusions of all causes acceptable morbidity rates. On the other hand, VATS and subxiphoid pericardial window should be performed in selected cases.