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Journal of Zhejiang University SCIENCE B 2009 Vol.10 No.7 P.547-551

http://doi.org/10.1631/jzus.B0820374


Video-assisted thoracoscopic surgery (VATS) for the treatment of hepatic hydrothorax: report of twelve cases


Author(s):  Shi-ping LUH, Chi-yi CHEN

Affiliation(s):  Vice Superintendent, Department of Thoracic Surgery, St Martin De Porres Hospital, Chia-Yi 60069, Taiwan, China; more

Corresponding email(s):   luh572001@yahoo.com.tw

Key Words:  Hepatic hydrothorax, Video-assisted thoracoscopic surgery (VATS), Pleurodesis


Shi-ping LUH, Chi-yi CHEN. Video-assisted thoracoscopic surgery (VATS) for the treatment of hepatic hydrothorax: report of twelve cases[J]. Journal of Zhejiang University Science B, 2009, 10(7): 547-551.

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author="Shi-ping LUH, Chi-yi CHEN",
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number="7",
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year="2009",
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doi="10.1631/jzus.B0820374"
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%A Shi-ping LUH
%A Chi-yi CHEN
%J Journal of Zhejiang University SCIENCE B
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%I Zhejiang University Press & Springer
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T1 - Video-assisted thoracoscopic surgery (VATS) for the treatment of hepatic hydrothorax: report of twelve cases
A1 - Shi-ping LUH
A1 - Chi-yi CHEN
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PB - Zhejiang University Press & Springer
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DOI - 10.1631/jzus.B0820374


Abstract: 
Background: hepatic hydrothorax is defined as a significant pleural effusion in patients with liver cirrhosis and without underlying cardiopulmonary diseases. Treatment of hepatic hydrothorax remains a challenge at present. Methods: Herein we share our experiences in the treatment of 12 patients with hepatic hydrothorax by video-assisted thoracoscopic surgery (VATS). Repair of the diaphragmatic defects, or pleurodesis by focal pleurectomy, talc spray, mechanical abrasion, electro-cauterization or injection was administered intraoperatively, and tetracycline intrapleural injection was used postoperatively for patients with prolonged (>7 d) high-output (>300 ml/d) pleural effusion. Results: Out of the 12 patients, 8 (67%) had uneventful postoperative course and did not require tube for drainage more than 3 months after discharge. In 4 (33%) patients the pleural effusion still recurred after discharge due to end-stage cirrhosis with massive ascites. Conclusion: We conclude that the repair of the diaphragmatic defect and pleurodesis through VATS could be an alternative of transjugular intrahepatic portal systemic shunt (TIPS) or a bridge to liver transplantation for patients with refractory hepatic hydrothorax. pleurodesis with electrocauterization can be an alternative therapy if talc is unavailable.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

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