van der Schelling G P, Michielsen D, Hendrickx L, Hubens A
Department of Surgery, General Hospital Stuivenberg, Antwerp, Belgium.
Acta Chir Belg. 1994 Sep-Oct;94(5):272-3.
Surgical treatment of pericardial effusions are, in general, treated by methods using a subxiphoid or a transthoracic route. The former is criticized for the high recurrence rate, the latter for the high incidence of respiratory complications. To minimize these problems and in view of the growing enthusiasm for using minimal invasive techniques, we treated one patient with pericardial effusion by using video-assisted thoracoscopy for the creation of a pericardial window. We achieved an adequate drainage, and the postoperative pain and pulmonary dysfunction were minimal. The operative technique and pitfalls are discussed in this report. Thoracoscopic pericardial fenestration might facilitate a much less aggressive transthoracic approach to the pericardium which is of great importance, as many of these patients are already in a poor clinical condition.
心包积液的外科治疗通常采用剑突下或经胸途径的方法。前者因复发率高而受到批评，后者因呼吸并发症发生率高而受到批评。为了尽量减少这些问题，并且鉴于对使用微创技术的热情日益高涨，我们通过电视辅助胸腔镜为一名心包积液患者创建心包开窗进行治疗。我们实现了充分引流，术后疼痛和肺功能障碍最小。本报告讨论了手术技术和陷阱。胸腔镜心包开窗术可能有助于采用对心包侵袭性小得多的经胸方法，这非常重要，因为这些患者中的许多人临床状况已经很差。
