Malignant Pericardial Effusions

Nistor, Claudiu; Ciuche, Adrian; Bontaș, Ecaterina; Horvat, Teodor

doi:10.1007/978-3-030-40679-0_55

Cited by 5 publications

(13 citation statements)

References 28 publications

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“…Imaging studies confirm the diagnosis of pneumothorax-chest radiography, computed tomography, and chest ultrasound [13]. Radiological examination is mandatory to highlight the air in the pleural cavity, with the absence of lung pattern [14]. Chest computed tomography highlights the triggering cause [lung bullae, lung emphysema, tumors, etc.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Therapeutic Characteristics in Patients with Pneumotorax Associated with COVID-19 versus Non-COVID-19 Pneumotorax

Nistor

Pantile²,

Stanciu-Gavan³

et al. 2022

Medicina

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Introduction: Pneumothorax is a condition that usually occurs in thin, young people, especially in smokers. It is an unusual complication of COVID-19 disease that can be associated with worse results. This disease can occur without pre-existing lung disease or without mechanical ventilation. Materials and Methods: We present a monocentric comparative retrospective study of diagnostic and treatment analysis of two groups of patients diagnosed with COVID-19 and non-COVID-19 pneumothorax. All patients included in this study underwent surgery in a thoracic surgery department. The study was conducted over a period of 18 months. It included 34 patients with COVID-19 pneumothorax and 42 patients with non-COVID-19 pneumothorax. Results: The clinical symptoms were more intense in patients with COVID-19 pneumothorax. We found that the patients with COVID-19 had significantly more respiratory comorbidities. Diagnostic procedures include chest CT exam for both groups. Laboratory findings showed that increasing values for the analyzed data were consistent with the deterioration of the general condition and the appearance of pneumothorax in the COVID-19 group. The therapeutic attitude regarding the non-COVID-19 group was to eliminate the air from the pleural cavity and surgical approach to the lesion that determined the occurrence of pneumothorax. The group of patients with COVID-19 pneumothorax received systemic treatment, and only minimal pleurotomy was performed. The surgical approach did not alter patients’ survival. Conclusions: Careful monitoring of the patient’s clinic and laboratory tests evaluating the degradation of the lung parenchyma, correlated with the imaging examination (chest CT) is mandatory and reduces COVID-19 complications. Early imaging examination starts an effective diagnosis and treatment management. In severe COVID-19 pneumothorax cases, the pneumothorax did not influence the evolution of COVID-19 disease. When we found that the general condition worsened with the rapid progression of dyspnea and the deterioration of the general condition, and we found that it represented the progression or recurrence of pneumothorax.

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Section: Discussionmentioning

confidence: 99%

Diagnostic and Therapeutic Characteristics in Patients with Pneumotorax Associated with COVID-19 versus Non-COVID-19 Pneumotorax

Nistor

Pantile²,

Stanciu-Gavan³

et al. 2022

Medicina

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“…Various drainage options have been used, 1 7 8 9 10 but the usual approach for concomitant pleural and pericardial effusions implies the creation of a pericardiopleural window (pleural cavity accessed via pericardial cavity) or pleuropericardial window (pericardial cavity accessed via pleural cavity). So far, subxiphoid mediastinoscopic pericardial window and VATS pericardial window has been described in the literature.…”

Section: Discussionmentioning

confidence: 99%

Subxiphoid Mediastinoscopic Autonomous Double Fenestration

Nistor

Cucu

Găvan

et al. 2022

Thorac Cardiovasc Surg

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The coexistence of pleural and pericardial effusions in frail patients with or without confirmed neoplasia necessitates the use of a minimally invasive technique that has a minor impact on the patient's general status and allows for fast fluid evacuation and biopsy sampling if necessary. We present a subxiphoid mediastinoscopic autonomous (simultaneous noncommunicating) double fenestration approach for these patients with both diagnostic and therapeutic advantages in selected cases. Using the mediastinoscope alone through the subxiphoid incision can considerably reduce the duration of operation, allow for fluid evacuation, and significantly alleviate the patient's symptoms. This method enables the sampling of pleural and pericardial fluids and targeted tissue, if necessary.

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“…The development of tension chylothorax after pneumonectomy for malignancy may be explained by the injury during subcarinal or subaortic dissection of small lymphatics that drain the lung or the mediastinal lymph nodes directly into the thoracic duct ( 21 ).…”

Section: Types Of Fluid In the Post-pneumonectomy Spacementioning

confidence: 99%

Tensioned space after pneumonectomy for cancer with mediastinal shift and cardiac tamponade‑causes and treatment (Review)

et al. 2022

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Regarding the pleural space after pneumonectomy for malignancy, a vast number of studies have assessed early drop in the fluid level, suggesting a broncho-pleural fistula, but only a small number of studies reported on the abnormal increase in the fluid level-a potentially lethal complication.In the present study, the available databases worldwide were screened and 19 cases were retrieved, including 14 chylothorax and 3 hydrothorax cases, 1 pneumothorax and 1 haemothorax case. Tension chylothorax is caused by mediastinal lymph node dissection as an assumed risk in radical cancer surgery. For tensioned haemothorax, the cause has not been elucidated, although lymphatic stasis associated with deep venous thrombosis was suspected. Tensioned pneumothorax was caused by chest wall damage after extrapleural pneumonectomy combined with low aspiration pressure on the chest drain. No cause was determined for none of the tensioned hydrothorax-all 3 cases had the scenario of pericardial resection in addition to pneumonectomy in common. Tensioned space after pneumonectomy for cancer manifests as cardiac tamponade. Initial management is emergent decompression of the heart and mediastinum. Final management depends on the fluid type (chyle, transudate, air, blood) and the medical context of each case. Of the 19 cases, 12 required a major surgical procedure as the definitive management.

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Malignant Pericardial Effusions

Cited by 5 publications

References 28 publications

Diagnostic and Therapeutic Characteristics in Patients with Pneumotorax Associated with COVID-19 versus Non-COVID-19 Pneumotorax

Diagnostic and Therapeutic Characteristics in Patients with Pneumotorax Associated with COVID-19 versus Non-COVID-19 Pneumotorax

Subxiphoid Mediastinoscopic Autonomous Double Fenestration

Tensioned space after pneumonectomy for cancer with mediastinal shift and cardiac tamponade‑causes and treatment (Review)

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