Background: Pericardial effusion is a common problem in patients with end-stage renal
disease (ESRD). There are many surgical approaches to perform a pericardial window in
those patients. This study compares the safety and efficacy of VATS and subxiphoid
approaches in performing a pericardial window for pericardial effusion in patients with
ESRD.
Method: From February 2015 to March 2017, a prospective study included a total number of
30 patients of ESRD who were prepared for pericardial window. Patients were randomly
divided into two groups: group A (15 patients who underwent VATS pericardial window),
and group B (15 patients who underwent subxiphoid pericardial window). Patients were
followed-up for 12 months postoperatively.
Results: Both procedures are safe and effective in the management of pericardial effusion.
Preoperative data showed no significant difference between both groups. In VATS group,
there were significant increased operative times (p-value = 0.031) but with a significantly
shorter length of hospital stay (p-value = 0.037) when compared to the subxiphoid group. In
both groups, no mortality was recorded. Recurrent pericardial effusion was detected in 5
patients (33.3%) in the subxiphoid group while it was detected in 1 patient (6.7%) in VATS
group (p-value =0.169). VATS approach was the independent predictor of freedom from
recurrence (hazard ratio: 0.054; p-value = 0.020)
Conclusion: VATS is a safe and effective procedure in the management of pericardial
effusion in patients with ESRD. VATS approach decreased total length of hospital stay and
decreased the incidence of recurrence of pericardial effusion. |
