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Surgical management of pericardial effusion in patients with malignancies. Comparison of subxiphoid window versus pericardiectomy
Author(s) -
Park Jeong Sik,
Rentschler Robert,
Wilbur David
Publication year - 1991
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19910101)67:1<76::aid-cncr2820670115>3.0.co;2-6
Subject(s) - medicine , pericardiectomy , pericardial window , pericardial effusion , surgery , malignancy , thoracotomy , pericardium , effusion
There is a lack of consensus regarding optimal surgical management of symptomatic pericardial effusions in patients with malignancies. Subxiphoid pericardial window formation (subxiphoid pericardial drainage) has been considered a safe and effective method for diagnostic and therapeutic purposes. To ensure adequate drainage, many surgeons prefer the formation of a larger pericardial window by performing either an anterior thoracotomy or a partial/total pericardiectomy. To evaluate the efficacy of these methods for palliation of symptomatic pericardial effusion in patients with malignancy, 28 consecutive pericardial surgery cases involving patients with malignancy were retrospectively analyzed. Ten patients (Group 1) had subxiphoid window formation, whereas 18 patients (Group 2) had partial or total pericardiectomy or pericardial window formation by anterior thoracotomy. There was no statistically significant difference ( P = 0.22) in the survival rates between these two groups. A median survival time of 2.67 months (range, 0.43 to 26.6 months) was observed in Group 1 versus 1.23 months (range, 0.03 to 10.83 months) in Group 2. However, a statistically significant difference ( P ± 0.02) in postoperative morbidity was observed between the two groups: 67% in Group 2 versus 10% in Group 1. Because of lower morbidity, subxiphoid pericardial window formation is recommended by this study as the preferred surgical method for palliation of symptomatic pericardial effusion in patients with malignancy.