VATS Pericardial Drainage in Cases of Recurrent Effusions

Introduction: The reasons for an increased amount of pericardial liquid could be different - malignant, infectious and rheumatoid diseases, myocardial infarct, uremia or mediastinal traumas which disturb the secretion and resorption processes.Materials and Methods: Clinical course, symptoms and general condition have been analyzed retrospectively for 32 patients, operated on with VATS for the period January, 2010– March, 2015. In 21 of the cases we diagnosed pleural effusions as well, in 12 cases – right-sided. In 6 of the patients, the pleural effusion was bilateral. Overall, the clinical symptoms of the pericardial effusion dominated. The patients included 15 males and 17 females from age 31 to 80 (mean 67 y/o). Ten of the patients were hospitalized with recurrent effusion, after sub-scaphoid pericardial drainage in another health facility. All patients were operated on with the VTS technique. The procedure was pericardial fenestration.Results: Overall, 33 VATS pericardial fenestrations were performed /23 with right approach, 9 with left one, and 1 bilateral / in 32 patients. In 25 of the cases, the pericardial effusions were malignant and in 7 – benign. The mean operative time was 25min. The chest tube was removed when the extravasation was under 150ml for 24 hours, most often on the 2nd post-operative day. No operative mortality was observed.Conclusions: We share other authors’ statement that early pericardial fenestration contributes to life style improvement as well as to life extension of cancer patients from 8 weeks to 7-8 months.