Chemical pleurodesis for hepatic hydrothorax

Boin, I.F.S.F.; Silva, Aurea Maria Oliveira; Leonardi, Luiz Sérgio

doi:10.1590/s0004-28032001000200008

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…Mechanical and chemical pleurodesis has been used successfully by cardiothoracic surgeons to eliminate pleuroperitoneal connections, as observed in the circumstance of hydrothorax secondary to elevated intraabdominal fluid pressure from ascites. 4 Therefore, it might help promote desired fibrogenesis in susceptible areas of the pleura because the pathophysiologies of these 2 processes are similar. We did not identify any complications associated with the use of chemical pleurodesis with tetracycline.…”

Section: Discussionmentioning

confidence: 99%

Circumferential dural resection technique and reconstruction for the removal of giant calcified transdural herniated thoracic discs

Walker

Kalani

Oppenlander

et al. 2018

Journal of Neurosurgery: Spine

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OBJECTIVEThe authors report a novel paradigm for resection of the disc or dural complex to treat giant calcified transdural herniated thoracic discs, and they describe a technique for the repair of dural defects. These herniated thoracic discs are uncommon, complicated lesions that often require a multidisciplinary team for effective treatment. The intradural component must be removed to effectively decompress the spinal cord. The opening of the friable dura mater, which frequently adheres to the extradural component of the disc, can result in large defects and difficult-to-manage CSF leaks.METHODSThe authors performed a retrospective study of the technique and outcomes in patients with a transdural herniated disc treated at St. Joseph’s Hospital and Medical Center within a 4-year period between 2012 and 2015.RESULTSDuring the study period, 7 patients (mean age 56.1 years) presented to the department of neurosurgery with clinical symptoms consistent with myeloradiculopathy. In all cases, 2-level corpectomies of the involved levels were combined with circumferential resection of the dura and complete decompression of the spinal cord. The dural defect was repaired with an onlay dural patch, and a large piece of AlloDerm (LifeCell Corp) graft was sewn to close the pleural defect. Every patient had a perioperative lumbar drain placed for CSF diversion. No patient suffered neurological decline related to the surgery, and 3 patients experienced clinically significant improvement in function. Two patients developed an early postoperative CSF leak that required operative revision to oversew the defects.CONCLUSIONSThis novel technique for decompression of the spinal cord by dural resection for the removal of giant calcified transdural herniated thoracic discs is safe and results in excellent decompression of the spinal cord. The technique becomes necessary when primary repair of the dura is not possible, and it can be used in cases in which the resection of pathology includes the dura.

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Section: Discussionmentioning

confidence: 99%