Video-assisted thoracoscopic pericardiectomy for malignant pericardial effusion.

BACKGROUND A malignant thoracic tumour often causes malignant pericardial effusion with cardiac tamponade. However, no standard treatment has yet been established. The purpose of this study was to clarify the utility of performing video-assisted thoracoscopic (VATS) pericardiectomy in patients presenting malignant pericardial effusion. PATIENTS AND METHODS VATS pericardiectomy was performed for 11 patients with malignant pericardial effusion from 2000 to 2010. The clinical characteristics and outcome of these patients were retrospectively analysed. Pericardial windows were created under general anaesthesia and single lung ventilation was performed using three trocars. RESULTS All patients were successfully managed by thoracoscopic resections. There were no surgical difficulties and the postoperative periods were uneventful. The performance status and Hugh-Jones classification both improved after treatment in nine and eight out of eleven cases, respectively. The average duration of chest tube drainage was seven days. No recurrent pericardial effusion was noted during follow-up. CONCLUSION The thoracoscopic approach was able to safely resect a sufficient amount of the pericardium and to provide sufficient surgical visualisation while being minimally invasive for patients with malignant pericardial effusion.