Laparoscopic transabdominal pericardial window

Totté, E.; Hee, R. Van; Brabant, Peter; Wollaert, Bart; Gheuens, Eric; Declerck, Sarah; Leys, J; Pelgrims, Gino; T, Dieudonné; Oei, Frans B S; Vandermotte, M

doi:10.1007/s004640090128

Cited by 12 publications

(2 citation statements)

References 10 publications

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“…Diagnostic laparoscopy remains standard in our institution for assessment of the diaphragm following a left thoracoabdominal penetrating injury, and SPW remains standard for pericardial washout. There are reports in the literature detailing transdiaphragmatic pericardial washout for recurrent pericardial effusions from non-surgical disease, 9 as well as planned transdiaphragmatic pericardial washout following suspected penetrating cardiac trauma. 10 It is evident, however, that most surgeons prefer either subxiphoid or transthoracic/thoracoscopic pericardial assessment.…”

Section: Discussionmentioning

confidence: 99%

Transdiaphragmatic pericardial washout post penetrating cardiac injury found incidentally at diagnostic laparoscopy

Wain¹,

Manchev²,

Bruce³

et al. 2022

South African Journal of Surgery

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A 22-year-old male presented following a precordial stab. He was haemodynamically and metabolically normal. Initial investigations did not reveal pericardial fluid or haemothorax. At diagnostic laparoscopy, we encountered haemoperi-toneum and a diaphragmatic injury through which the heart was visible. After pericardial washout, laparoscopic repair was effected. This case highlights a potential problem with extended focused assessment with sonography in trauma (eFAST) in that it will only be positive if there is an accumulation of pericardial fluid. It also confirms the utility of diagnostic laparoscopy for penetrating left thoracoabdominal injuries and shows that principles of open surgery can be safely applied laparoscopically in select patients.

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Section: Discussionmentioning

confidence: 99%

Transdiaphragmatic pericardial washout post penetrating cardiac injury found incidentally at diagnostic laparoscopy

Wain¹,

Manchev²,

Bruce³

et al. 2022

South African Journal of Surgery

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“…Formation of a transdiaphragmatic pericardial window, first described in 1992 [ 1 ], has been identified as a simple and safe approach to management of recurrent pericardial effusion [ 2 ]. This approach eliminates the need for indwelling chest-drains and single-lung ventilation [ 3 ]. However, the creation of communication between the pericardial and peritoneal cavities can result in an iatrogenic intrapericardial hernia.…”

Section: Introductionmentioning

confidence: 99%

Iatrogenic diaphragmatic herniation of the liver into the pericardium—a case report

Wood

Simpson

Yuide

et al. 2023

Journal of Surgical Case Reports

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Iatrogenic diaphragmatic herniation is rare. This case is an example of herniation of the liver into the pericardial space post-transdiaphragmatic pericardial window formation for recurrent pericarditis. This case highlights that transdiaphragmatic herniation of intra-abdominal organs should be considered in patients presenting with gastrointestinal or cardiorespiratory symptoms with history of iatrogenic diaphragmatic defect.

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Ten-Year Surgical Experience With Nontraumatic Pericardial Effusions

Liberman

Labos²,

Sampalis³

et al. 2005

Arch Surg

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The approach to pericardial window in patients with nontraumatic pericardial effusion impacts outcome. Design: Retrospective review and comparison of all cases of pericardial window performed over 10 years. Follow-up was to patient death. Setting: Three hospitals performing cardiothoracic surgery at a single university. Patients: All patients in whom pericardial window was performed for nontraumatic pericardial effusion. Main Outcome Measures: Outcomes associated with the subxyphoid approach to pericardial window were compared with those associated with the transthoracic approach. The primary outcome was postsurgical recurrence of pericardial effusion. Secondary outcomes included operative time, intraoperative and postoperative complications, in-hospital mortality, hospital and intensive care unit lengths of stay, and days between surgery and death. Results: Over 10 years, there were 342 patients with procedural codes for pericardial window in the medical record databases of 3 hospitals performing cardiothoracic surgery at 1 university center. One hundred fifty-one patients were excluded because the operation was performed for trauma, postoperative tamponade, or pericardial biopsy without effusion. The results are, therefore, based on the remaining 191 procedures. The subxyphoid approach was used in 78 patients, and the transthoracic approach in 113 patients. Patients were well matched for age (P=.31), sex (P=.05), preoperative tamponade (P =.08), and comorbidities (PϾ .05). No differences were observed between the 2 approaches in terms of recurrence of effusion, operative time, overall intraoperative or postoperative complications, and hospital or intensive care unit lengths of stay. In-hospital mortality was significantly greater in the subxyphoid group (27 of 78 vs 18 of 113 patients; P =.003). Conclusions: Over 10 years, there were 191 pericardial windows performed for nontraumatic pericardial effusions. The subxyphoid and transthoracic approaches were well tolerated by patients, required short operative times, and resulted in similar rates of overall postoperative complications and intensive care unit and hospital lengths of stay. Recurrence rates were low with both procedures.

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Laparoscopic transabdominal pericardial window

Cited by 12 publications

References 10 publications

Transdiaphragmatic pericardial washout post penetrating cardiac injury found incidentally at diagnostic laparoscopy

Transdiaphragmatic pericardial washout post penetrating cardiac injury found incidentally at diagnostic laparoscopy

Iatrogenic diaphragmatic herniation of the liver into the pericardium—a case report

Ten-Year Surgical Experience With Nontraumatic Pericardial Effusions

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