Sakamoto K, Tsuchida K, Ariga T
Department of Respiratory Surgery, Yokohama Rosai Hospital, Yokohama, Japan.
Kyobu Geka. 2002 Nov;55(12):1077-80.
We performed thoracoscopic pericardial fenestration for persistent pericardial effusion after radiotherapy for esophageal cancer. An 85-year-old man who had radiation therapy (70.2 Gy) for esophageal cancer was admitted for shortness of breath. Chest computed tomography showed a pericardial effusion. During the 6 months prior to this admission, the patient had undergone percutaneous pericardial drainage 3 times for cardiac tamponade. We performed thoracoscopic partial pericardiectomy with creation of a pleuropericardial window via one access port. Histopathologically, no malignant cells were found in either the resected pericardium or the pericardial effusion. Therefore, we believe the persistent pericardial effusion was secondary to radiotherapy. There was no recurrence of the pericardial effusion for 7 months postoperatively. In summary, thoracoscopic pericardial fenestration is useful in both the diagnosis and treatment of persistent pericardial effusion.
我们对一名食管癌放疗后出现持续性心包积液的患者实施了胸腔镜下心包开窗术。一名接受过食管癌放疗(70.2 Gy)的85岁男性因气短入院。胸部计算机断层扫描显示有心包积液。在此次入院前的6个月里,该患者因心脏压塞接受了3次经皮心包穿刺引流。我们通过一个操作孔进行了胸腔镜下部分心包切除术并建立了胸膜心包窗。组织病理学检查显示,切除的心包和心包积液中均未发现恶性细胞。因此,我们认为持续性心包积液是放疗的继发结果。术后7个月心包积液未复发。总之,胸腔镜下心包开窗术在持续性心包积液的诊断和治疗中均有用。