The main aim of this study is to analyze all cases of pericardial effusions - except post
cardiac procedures - who were admitted to surgical department in Al-Assad and Tichreen
University Hospital in the period between 2007-2016.
(63) cases of Per
icardial effusions were analyzed, (38) male and (25) female, their ages
were ranging between (17-67) years.
The most important two causes of pericardial effusions were renal failure (50.7%) and
Malignancies (34.9%). lung cancer was the leading cause of Malignancies accounting
17.4% of whole cases and 50% of Malignancies.
Pericardial window via left mini thoracotomy was the preferred procedure in our study.
68.2% of the patients under went this procedure, recurrent rate was 4.6%, and the amount
of recurrent pericardial effusion was minimal and didn’t need any management.
Pericardiocentesis was performed in 39.6% of our patients, recurrent rate was very high
80%, therefore it was abondend as a method of treatment and its role was considered only
in hemodynamically unstable patients or as a first step of preparation for pericardial window.
Pericardial window via subxyhoid under local anesthesia was performed in 11.11%;
recurrent rate was high 28.6%.We consider this approach only in patients who are not fit to
undergo other approaches or when the expected survival is very limited.
Pericardial window via thoracoscopic approach was performed in 15.8% of our patients;
recurrent rate was 10% with encouraging results. During performance of pericardial
window via minithoracotomy or thoracoscopically we were able to perform in (19) patients
many other diagnostic and therapeutic procedures such as pleurectomy, Biopsies from the
lungs, mediastinal tumors, and mediastinal lymph nodes as well.
The histopathological examination of the resected pericardial window and concurrent
procedures played an important diagnostic role in 23.8% of idiopathic pericardial
effusions.
The diagnosis of pleural diseases is one of the frequent clinical problems. Despite a
variety of diagnostic tests are available for evaluating pleural effusions, approximately 15–
20% of pleural effusions remains undiagnosed, In this cases ,a thora
coscopy plays an
important role, it permits the surgeon to visually view and evaluate the entire pleural space
,and to obtain enough accurate biopsies from suspected areas. This study aims to evaluate
the effectivenes of Video Assisted
Thoracoscopic surgery (VATS) in diagnosis of pleural effusions.
Between June 2012 and June 2015 we performed 38diagnostic thorososcopy for
undiagnosed pleural effusions. The histopathologic studies of pleural biopsies result were
as follows : )%60,5 ( malignancies,)%31,6 ( TB And )%7,9 ( nonspecific inflammatory
reaction.
The malignant diseases are: Mesothelioma )%60,9(, Metastases of adenocarcinoma
)%30,4(,Lymphoma )% 8,7(
4 Complications ,with no mortality.
Conclusion: Video Assisted Thoracoscopic Surgery is a safe and accurate diagnostic
procedure for pleural diseases but it also has a very useful role in therapy.(VATS) saves
time, effort and cost, more over it is preferred by the patient as he recovers and returns to
his normal activity rapidly.