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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 2001 Giugno;42(3):415-9

lingua: Inglese

Pericardial catheter sclerosis versus surgical procedures for pericardial effusions in cancer patients

Anderson T. M., Ray C. W. *, Nwogu C. E., Bottiggi A. J., Lenox J. M., Driscoll D. L., Urschel J. D.

From ­the Department of Thoracic Surgical Oncology
*Division of Radiation Medicine State University of New York & Roswell Park Cancer Institute Buffalo, New York, ­USA


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Background. Approximately 21% of ­patients ­with ­advanced malig­nan­cies ­have car­diac or per­i­car­dial involve­ment ­with ­tumor. Controversy ­exists regard­ing ­the opti­mal ­approach to ­the per­i­car­dial ­space ­when hemo­dy­nam­ic com­pro­mise ­due to effu­sions ­occurs.
Methods. A ­six-­year ret­ro­spec­tive ­review of 59 can­cer ­patients ­with per­i­car­dial effu­sions.
Results. Thirty-­six ­patients ­had subx­i­phoid per­i­car­dial win­dow (­SXPW) ­alone (­Group A), 5 ­had per­i­car­dial cath­e­ter drain­age (­PCD) fol­lowed by a ­SXPW (Group B), 10 ­had ­PCD ­with scler­o­sis (­Group C), 5 ­had ­PCD ­alone (­Group D), 2 ­had ­PCD ­with per­i­car­dial-pleu­ral win­dow (­Group E), ­and ­one ­had per­i­car­dial-per­i­to­neal win­dow (­Group F). The meth­od of pro­ce­dure, com­pli­ca­tions, num­ber of hos­pi­tal ­and ­ICU ­days, cyto­log­i­cal or path­o­log­ic evi­dence of malig­nan­cy, sol­id ver­sus hemat­o­log­i­cal ­tumors, ­and sur­vi­val ­were ana­lyzed. The ­median sur­vi­val ­for ­those ­patients in ­group C ­was ­one ­month com­pared to 4 ­months ­for Group A ­and 6 ­months ­for Group B. Essentially, ­results ­were sim­i­lar regard­less of meth­od per­formed ­with ­the excep­tion ­that pro­fes­sion­al ­and hos­pi­tal charg­es aver­aged $4830 ­for ­SXPW com­pared to $1625 ­for ­PCD.
Conclusions. Pericardial cath­e­ter drain­age ­and scler­o­sis pro­vides a ­viable ­option ­for ­the treat­ment of per­i­car­dial effu­sions in select­ed can­cer ­patients at mark­ed­ly ­reduced ­cost ­and ­patient dis­com­fort.

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