Simple surgical treatment for pleuroperitoneal communication without interruption of continuous ambulatory peritoneal dialysis

Abstract

Pleuroperitoneal communication is a complication of continuous ambulatory peritoneal dialysis (CAPD) that can necessitate cessation of CAPD. Hemodialysis was started on a 52-year-old woman and shifted to CAPD 1 month later. However, 18 days after initiation of CAPD, her chest radiograph showed a right-side hydrothorax. Thoracentesis yielded a colorless pleural effusion with markedly higher glucose levels than in her serum, indicating the presence of pleuroperitoneal communication. Three days later, thoracoscopic surgery was performed. A colored dialysis solution preoperatively injected into the abdominal cavity identified intraoperatively leakage from the diaphragm. The leakage points were closed by a no-knife-type automatic stapler with absorbable polyglycolic acid felt and fibrin glue. CAPD was restarted on the operative day, and there was no recurrence of the right hydrothorax. We conclude that this simple method can be used effectively to treat pleuroperitoneal communication.

Pleuroperitoneal Communication and Ovarian Cancer Complicating Peritoneal Dialysis: A Case Report of a Patient with End-Stage Kidney Disease

“… 8 , 11 – 13 , 29 Even restarting PD with low volumes on the operative day has been reported anecdotally. 30 On the other hand, one report has described the impact of gynecologic surgeries on the continuation of PD, reporting on 3 patients who underwent hysterectomy. All patients were shifted to HD in the immediate postoperative period, and PD was successfully restarted after 2 to 4 weeks.…”

Pleuroperitoneal Leak Complicating Peritoneal Dialysis: A Case Series

“…One group advocates early diaphragmatic repair and continuation of peritoneal dialysis [12]. In this case, thorascopic diaphragmatic repair was performed using absorbable polyglycolic acid felt, and fibrin glue [12]. …”

Second surgical procedures for continuous ambulatory peritoneal dialysis patients: An analysis of 148 cases

“…We successfully treated hydrothorax with direct repair of the diaphragm perforation via video‐assisted thoracic surgery and concluded that direct repair was the best method to cure this problem 26 . Others have also had a similar experience 27,28 . Although the open method to repair the diaphragm 29 or pleurodesis have been applied, 25 we still regard video‐assisted thoracoscopic surgery repair as the best method.…”