Examination of surgical treatment for pleuroperitoneal communication

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  • 横隔膜交通症に対する手術治療―当科経験例7例と本邦報告例32例の検討―

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Abstract

<p>Pleuroperitoneal communication is a rare disease associated with the conditions in which ascites accumulates. Although there are some case reports, standard treatment has not been established. We examined seven thoracoscopic surgical cases of pleuroperitoneal communication which we encountered between 2018 and 2022. Six of the patients were male and one was female. The mean age was 56.4 years. The causative diseases were continuous ambulatory peritoneal dialysis (CAPD) in two cases, and hepatic pleural effusion in five cases. All patients had right-sided lesions. The fistulas were detected by the dye method with indigo carmine, or pneumoperitoneum with CO2. The rate of identifying leakage points was 57.1%. For cases in which the communication lesion was identified, the lesion was resected or sutured, with reinforcement involving a polyglycolic acid sheet and fibrin glue. In cases whereby the communication lesion was not identified, the entire diaphragm was covered with the same material. There was no recurrence case. We discuss the standard strategy for pleuroperitoneal communication syndrome, with a literature review.</p>

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