Video-assisted Thoracoscopic PGA Sheet Coverage of the Entire Diaphragm for Refractory Hepatic Hydrothorax—A Case Report—
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- NAKANE Shigeru
- Department of General Thoracic Surgery, JCHO Hoshigaoka Medical Center
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- MURATA Masaru
- Department of Surgery, JCHO Hoshigaoka Medical Center
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- SUZUKI Rei
- Department of Surgery, JCHO Hoshigaoka Medical Center
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- HIROTA Masashi
- Department of Surgery, JCHO Hoshigaoka Medical Center
Bibliographic Information
- Other Title
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- 胸腔鏡補助下全横隔膜PGAシート被覆が有効であった難治性肝性胸水の1例
- キョウコウキョウ ホジョ カ ゼン オウカクマク PGA シート ヒフク ガ ユウコウ デ アッタ ナンチセイ カンセイ キョウスイ ノ 1レイ
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Abstract
<p>A 74-year-old man with previous histories of liver cirrhosis, hepatocellular carcinoma, spinal cord injury, colon cancer, and lung cancer in the left upper lobe was brought into our emergency room with dyspnea. He was admitted to the hospital for thoracic cavity drainage due to massive right pleural effusion. Repeated pleurodesis procedures were not effective. Thus, surgery was performed with video-assisted thoracoscopy through an access thoracotomy together with laparoscopy. Air leak through the diaphragm could not be observed after filling the thoracic cavity with normal saline during insufflation of the peritoneal cavity with 12 cmH2O. However, visualization through the laparoscope revealed a defect in the central tendon of the diaphragm, which was sutured, though the diaphragm was fragile and became torn from the needle puncture. Direct closure was abandoned, and the entire diaphragm was covered with polyglycolic acid (PGA) sheets that were fixed with fibrin glue. The chest tube was removed on postoperative day 9, with no re-accumulation of pleural fluid observed thereafter. In the present case, while direct closure could not be achieved because of the thinned diaphragm, hepatic hydrothorax was successfully treated with PGA sheet coverage of the entire diaphragm.</p>
Journal
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- Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
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Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 83 (7), 1239-1243, 2022
Japan Surgical Association
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Details 詳細情報について
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- CRID
- 1390013474494911360
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- NII Book ID
- AA11189709
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- ISSN
- 18825133
- 13452843
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- NDL BIB ID
- 032320346
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
- Crossref
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- Abstract License Flag
- Disallowed