Kuga T, Sudo M, Shigeta M, Yamashita A, Nakayama T, Fujii Y
Department of Surgery, Nagato General Hospital, Nagato, Japan.
Kyobu Geka. 2006 Jun;59(6):512-5.
We report a case of malignant pericardial effusion after lung cancer surgery treated with thoracoscopic pericardial fenestration. The patient was admitted to our hospital because of dyspnea. Computed tomography (CT) and ultrasound cardiography (UCG) revealed cardiac tamponade which was diagnosed as carcinomatous pericarditis by cytology. We attempted to inject 25 mg of cisplatin (CDDP) into the pericardial space twice. The response of the treatment was unexpectedly poor for the patient. The thoracoscopic pericardial fenestration was performed and the patient was discharged without a drainage tube on the 17th postoperative day. Malignant pericardial effusion is a common complication of advanced cancers and is often associated with significant morbidity. Thoracoscopic pericardial fenestration appears to be a safe, effective and minimally invasive treatment for patients with malignant pericardial effusion. This surgery might also have a favorable effect on the improvement of the quality of life for patients with malignant pericardial effusion resistant to chemotherapy.
我们报告了1例肺癌手术后发生恶性心包积液并接受胸腔镜心包开窗引流术治疗的病例。该患者因呼吸困难入院。计算机断层扫描（CT）和超声心动图（UCG）显示心脏压塞，经细胞学检查诊断为癌性心包炎。我们尝试两次向心包腔内注射25mg顺铂（CDDP）。但该患者的治疗反应出乎意料地差。遂进行了胸腔镜心包开窗引流术，术后第17天患者出院，未留置引流管。恶性心包积液是晚期癌症的常见并发症，常伴有严重的发病率。胸腔镜心包开窗引流术对于恶性心包积液患者似乎是一种安全、有效且微创的治疗方法。该手术对于化疗耐药的恶性心包积液患者的生活质量改善可能也有积极作用。
