Perikardiyal effüzyonlarda subksifoid perikardiyal pencere operasyonu

Amaç: Bu çalışmanın amacı, perikardiyal effüzyonların tedavisinde subksifoid pencere operasyonunun etkinliğinin ve komplikasyon durumunun ortaya konmasıdır. Yöntem: 1985-1999 tarihleri arasında Selçuk Üniversitesi Kalp Damar Cerrahisi Kliniğinde perikardiyal effüzyon tanısı alan 55 hastaya subksifoid perikardiyal pencere operasyonu uygulandı. Kardiyak konstriksiyon saptanmadığından hiçbir hastada perikardiektomi uygulanmadı. Bulgular: Perikardiyal effüzyon 1 hastada malign, diğer hastalarda benign nedenli idi. Mortalite olmadı. Sonuç: Bu metod ile genel durumları kötü olan hastalara zarar vermeksizin perikardiyal kavite kolaylıkla değerlendirilebilmektedir. Kesin teşhis ve tedavi yanında uygulama kolaylığı nedeni ile bu yöntem tavsiye edildi.

Subxiphoidal pericardial window operation in pericardial effusions

Objevtive: Subxiphoidal pericardial window operation is an effective treatment of pericardial effusions without any complication. Methods: Subxiphoid pericardial drainage procedure performed to 55 patients between 1985 to 1999 at the Cardiovascular Surgery Clinic of Selcuk University. Since cardiac constriction did not occur, pericardiectomy was not performed. Results: The pericardial effusions were malignant in 1 patient and benign in the others. There was no mortality and all the patients relieved by operation. Conclusion: In patients whose general situations are poor, pericardial cavity can be easily seen by this method without giving any injury to them. This procedure was recommended because of its simplicity, diagnostic and treatment effectivities.

___

  • Özpınar C, Ceran S, Yeniterzi M, Yüksek T, Özergin U, Solak H. Kardiyak tamponada giden perikardiyal effüzyonlarda subksifoidal perikardiyotomi. Cerrahi Tıp Bülteni 1993;2:98-103.
  • Sugimoto JT, Little AG, Ferguson MK, Borow KM, Vallera D, Staszak VM, et al. Pericardial window: Mechanisms of efficacy. Ann Thorac Surg 1990;50:442-5.
  • Fontenelle LJ, Cuello L, Dooley BN. Subxiphoid pericardial window. Am J Surg 1970;120:679-80.
  • Little AG, Kremser PC, Wade JL, Levett JM, DeMeester TR, Skinner DB. Operation for diagnosis and treatment of pericardial effusions. Surg 1984;96:738-44.
  • Piehler JM, Pluth JR, Schaff HV, Danielson GK, Orszulak TA, Puga FJ. Surgical management of effusive pericardial disease. J Thorac Cardiovasc Surg 1985;90:506-16.
  • Allen KB, Faber LP, Warren WH, Shaar CJ. Subxiphoid pericardiostomy versus percutaneous catheter drainage. Ann Thorac Surg 1999;67:437-40.
  • Tsang TS, Barnes ME, Hayes SN, Freeman WK, Dearani JA, Butler SL, et al. Clinical and echocardiographic characteristics of significant pericardial effusions following cardiothoracic surgery and outcomes of echo-guided pericardiocentesis for management: Mayo Clinic experience, 1979-1998. Chest 1990;116:322-31.
  • de Divitiis M, Dialetto G, Covino FE, Caruso A, Cotrufo M. An unusual procedure for the treatment of simultaneous pericardial and pleural effusions. G Ital Cardiol 1999;29:796-8.
  • Mills SA, Julian S, Holliday RH, Vinten-Johansen J, Case LD, Hudspeth AS, et al. Subxiphoid pericardial window for pericardial effusive disease. J Cardiovasc Surg 1989;30:768-73.
  • Mueller XM, Tevaearai HT, Hurni M, Ruchat P, Fischer AP, Stumpe F, et al. Long-term results of surgical subxiphoid pericardial drainage. Thorac Cardiovasc Surg 1997;45:65-9.
  • Olson JE, Ryan MB, Blumenstock DA. Eleven years’ experience with pericardial–peritoneal window in the management of malignant and benign pericardial effusions. Ann Surg Oncol 1995;2:165-9.
  • Palatianos GM, Thurer RJ, Pompeo MQ, Kaiser GA. Clinical experience with subxiphoid drainage of pericardial effusions. Ann Thorac Surg 1989;48:381-5.
  • Fox HE, Yee JM, Weaver JC Jr, Dugan DJ, Samson PC. Pericardial drainage operations in the management of uremic pericardial effusions. J Thorac Cardiovasc Surg 1997;73:504-10.