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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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

Copyright © 2009 EDIZIONI MINERVA MEDICA

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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