Thoracoscopic diaphragmatic repair for refractory hepatic hydrothorax: Application of pleural flap and mesh onlay reinforcement
Journal
Thoracic and Cardiovascular Surgeon
Journal Volume
54
Journal Issue
1
Pages
47-50
ISBN
16485189
Date Issued
2006
Author(s)
Abstract
Background: Management of hepatic hydrothorax is difficult, and no radical treatment has been established. Based on accumulating evidence that diaphragmatic defects contribute to hepatic hydrothorax, we developed a diaphragmatic repair method for the management of this complex condition. Methods: From October 2003 to March 2005,10 patients (age, 32-83 years; 6 men and 4 women) with refractory hepatic hydrothorax (Child-Pugh class B-C) underwent thoracoscopic pleura (n = 7) or mesh (n = 3) onlay reinforcement to repair the diaphragmatic defects on which this study focuses, and all patients have since been under follow-up in a prospective observation study. Results: After a mean of 7.7 months of follow-up examinations, no local recurrence occurred in all patients. Two patients died of hemorrhage from esophageal varices two months postoperatively. All patients had a better postoperative pulmonary function. Conclusion: The use of pleura and mesh onlay reinforcement of the diaphragm is an encouraging treatment for refractory hepatic hydrothorax. ? Georg Thieme Verlag KG.
SDGs
Other Subjects
adult; aged; article; bleeding; clinical article; clinical observation; diaphragm injury; diaphragm repair; esophagus varices; female; follow up; hepatic hydrothorax; human; liver disease; lung function; male; pleura; pleural flap and mesh onlay reinforcement; postoperative period; priority journal; prospective study; skin flap; surgical technique; thoracoscopy; tissue repair; Adult; Aged; Aged, 80 and over; Diaphragm; Esophageal and Gastric Varices; Female; Follow-Up Studies; Humans; Hydrothorax; Liver Cirrhosis; Male; Middle Aged; Pleural Effusion; Prospective Studies; Surgical Flaps; Surgical Mesh; Survival Analysis; Thoracoscopy; Treatment Outcome
Type
journal article