Nakai Shingo, Uchida Tetsuro, Kuroda Yoshinori, Yamashita Atsushi, Hirooka Syuuto, Kobayashi Kimihiro, Hamasaki Azumi, Sadahiro Mitsuaki
Department of the Second Surgery, Yamagata University, Yamagata, Japan.
Kyobu Geka. 2020 Feb;73(2):108-112.
We present a case of palliative pleuro-peritoneal shunt for refractory hydrothorax complicated with unresectable cardiac tumor. The patient was a 77-year-old woman, who was admitted to our hospital for evaluation of intractable pleural effusion. It was attributed to severe diastolic dysfunction associated with cardiac tumor. The cardiac tumor occupied a large area of the anterior surface of the right atrium, and curative surgical resection was difficult. Therefore, we planned multidisciplinary staged treatment with chemotherapy followed by tumor excision. Persistent intractable bilateral pleural effusion necessitated repeat chest drainage. To maintain the patient's quality of daily life, bilateral pleuro-peritoneal shunts were inserted. Then, the problem of pleural effusion was resolved and her symptoms were improved. However, she expired 3 months later, due to deterioration of general condition. Pleuro-peritoneal shunting is a useful palliative approach to improve quality of life in patients with refractory hydrothorax.
我们报告一例因难治性胸腔积液合并不可切除心脏肿瘤而行姑息性胸腹分流术的病例。患者为一名77岁女性，因顽固性胸腔积液入院接受评估。胸腔积液归因于与心脏肿瘤相关的严重舒张功能障碍。心脏肿瘤占据右心房前表面的大片区域，难以进行根治性手术切除。因此，我们计划采用多学科分期治疗，先进行化疗，然后切除肿瘤。持续性双侧顽固性胸腔积液需要反复胸腔引流。为维持患者的日常生活质量，插入了双侧胸腹分流管。随后，胸腔积液问题得到解决，她的症状有所改善。然而，3个月后她因全身状况恶化而死亡。胸腹分流术是一种改善难治性胸腔积液患者生活质量的有用姑息治疗方法。
