TY  - JOUR
T1  - Recommendations for Overcoming Difficulties in Video Assisted Thoracoscopic Pericardial Fenestration
TT  - Video Yardımlı Torakoskopik Perikardiyal Pencere Uygulamasında Karşılaşılan Zorluklar için Öneriler
AU  - Gürz, Selçuk
AU  - Deşer, Serkan Burç
AU  - Temel, Necmiye Gül
PY  - 2022
DA  - August
DO  - 10.46332/aemj.1002463
JF  - Ahi Evran Medical Journal
JO  - Ahi Evran Med J
PB  - Kirsehir Ahi Evran University
WT  - DergiPark
SN  - 2619-9203
SP  - 197
EP  - 202
VL  - 6
IS  - 2
LA  - en
AB  - Purpose: Pericardial fenestration is used to treat recurrent pericardial effusion. This study aimed to assess the issues and solutions inpericardio-pleural fenestration (PPF) applications using video-assisted thoracoscopic surgery (VATS), which is more prominent today.Materials and Methods: Between July 2018 and December 2020, a total of 8 patients (3 males, 5 females; median age: 51.8 years,range: 23–65 years), who underwent VATS PPF in the Ondokuz Mayıs University Faculty of Medicine, were retrospectively evaluatedusing the hospital database and the findings were compared with the results reported in previous literature.Results: The amount of pericardial fluid drained and the measurement of fluid next to the inferior wall on echocardiography had astatistically significant positive and high correlation (p=.032). Shorter surgical time was correlated with the right lateral 45° positionand single port interventions (p=.020). The average time to remove the chest tube was 3.1 days (min: 2.0-max: 7.0), and the averagetime to discharge was 6.1 days (min: 3.0-max: 10.0).Conclusion: VATS PPF conducted through the 4th intercostal space with a single port in the right lateral 45° position is a procedurethat can be safely used in patients with recurrent pericardial effusion, despite the type of therapy.
KW  - pericardial effusion
KW  - pericardial fenestration
KW  - VATS
N2  - Amaç: Perikardiyal pencere, tekrarlayan perikardiyal efüzyonu tedavi etmek için kullanılır. Bu çalışmada, günümüzde daha çok öneçıkan video yardımlı torakoskopik cerrahi (VATS) kullanılarak perikardiyo-plevral pencere (PPF) uygulamalarında yaşanan sorunlarınve çözüm önerilerinin değerlendirilmesi amaçlanmıştır.Araçlar ve Yöntem: Temmuz 2018 - Aralık 2020 tarihleri arasında Ondokuz Mayıs Üniversitesi Tıp Fakültesi'nde VATS PPF uygulanan toplam 8 hasta (3 erkek, 5 kadın; ortanca yaş: 51.8 yıl, aralık: 23-65 yıl), retrospektif olarak değerlendirildi ve bulgular literatürdebildirilen sonuçlarla karşılaştırıldı.Bulgular: Ekokardiyografide inferior duvara komşu ölçülen sıvı ile boşaltılan perikardiyal sıvı miktarı arasında istatistiksel olarakanlamlı pozitif korelasyon vardı (p=.032). Daha kısa cerrahi süre, sağ lateral 45° pozisyon ve tek port müdahaleleri ile korele idi (p=.020). Göğüs tüpünün ortalama çıkarılma süresi 3,1 gün (min: 2,0-maks: 7,0) ve ortalama taburcu olma süresi 6,1 gündü (min: 3,0-maks: 10,0).Sonuç: Sağ lateral 45° pozisyonda tek port ile 4. interkostal aralıktan gerçekleştirilen VATS PPF, tedavi şekline rağmen tekrarlayanperikardiyal efüzyonu olan hastalarda güvenle kullanılabilecek cerrahi tedavi yöntemidir.
CR  - 1. Mouton W, Miirmann J, Mouton K. Survival Following Video-Assisted Thoracic and Mini-Thoracotomy Pericardial Fenestration. Int Surg. 2018;103(3-4):222-226.
CR  - 2. Georghiou G, Stamler A, Sharoni E, et al. Video-assisted thoracoscopic pericardial window for diagnosis and management of pericardial effusions. Ann Thorac Surg. 2005;80(2):607-610.
CR  - 3. Geissbuhler K, Leiser A, Fuhrer J, Ris H. Video-assisted thoracoscopic pericardial fenestration for loculated or recurrent effusions. Eur J Cardiothorac Surg. 1998;14(4):403-408.
CR  - 4. Miller J. Therapeutic Thoracoscopy - New Horizons for an Established Procedure. Ann Thorac Surg. 1991;52(5):1036-1037.
CR  - 5. Sagrista-Sauleda J, Angel J, Permanyer-Miralda G, Soler-Soler J. Long-term follow-up of idiopathic chronic pericardial effusion. New Engl J Med. 1999;341(27):2054-2059.
CR  - 6. Fernandez J, Robles R, Acosta F, Sansano T, Parrilla P. Cardiovascular changes during drainage of pericardial effusion by thoracoscopy. Brit J Anaesth. 2004;92(1):89-92.
CR  - 7. Dogusoy I, Koc T, Demirbag H, et al. Comparison of VATS and thoracotomy in treatment of patients with pericardial effusion. Turk Gogus Kalp Dama. 2011;19(4):607-612.
CR  - 8. Ohuchi M, Inoue S, Ozaki Y, Namura Y, Ueda K. Single-trocar thoracoscopic pericardio-pleural fenestration under local anesthesia for malignant pleural effusion: a case report. Surg Case Rep. 2019;5(1):136.
CR  - 9. Gonzalez-Rivas D, Stupnik T, Fernandez R, et al. Intraoperative bleeding control by uniportal video-assisted thoracoscopic surgerydagger. Eur J Cardiothorac Surg. 2016;49(1):17-24.
CR  - 10. Caspari G, Bartel T, Mohlenkamp S, et al. [Contrast medium echocardiography-assisted pericardial drainage]. Herz. 2000;25(8):755-760.
CR  - 11. Fibla J, Molins L, Mier J, Vidal G. Pericardial window by videothoracoscope in the treatment of pericardial effusion and tamponade. Cir Esp. 2008;83(3):145-148.
CR  - 12. Bary M, Abdel-aal K, Mohamed R, Abdel-maboud A, Helmy A. Video-assisted thoracoscopic pericardial window for massive pericardial effusion: South Egypt experience. Journal of the Egyptian Society of CardioThoracic Surgery. 2017;25(1):73-78.
UR  - https://doi.org/10.46332/aemj.1002463
L1  - https://dergipark.org.tr/en/download/article-file/2001205
ER  -