<abstract xmlns="http://www.w3.org/1999/xhtml"><sec><h3>Introduction</h3><p>Neoplastic pericarditis may develop in any type of cancer, but it is found more frequently in lung cancer, breast cancer and lymphoma.</p></sec><sec><h3>Methods</h3><p>We studied 156 consecutive oncological patients presented with pericardial fluid between 2010 and 2015. Among them, 80 patients were stable, with no indication for pericardial drainage or biopsy, and 76 patients needed surgery to evacuate the pericardium and obtain biopsy.</p></sec><sec><h3>Results</h3><p>Echocardiography and computed tomography were essential in evaluating the topography of the pericardial fluid and the haemodynamic effect, and these investigations helped us choose the appropriate surgical procedure. We performed pericardiocentesis, subxiphoid pericardial drainage, left paraxifoidian pericardial drainage, pericardio-pleural window through intercostal video-assisted thoracic surgery (VATS) or through classical thoracic surgery. Twenty-three patients (14.7%) were admitted and treated for cardiac tamponade. The rate of recurrence after pericardial drainage was 3.89%. The immediate survival at 48 h was 97.3%.</p></sec><sec><h3>Conclusion</h3><p>Long-term survival in patients with malignancy and drained pericardial effusion is influenced mainly by the type of underlying malignant disease. We observed a better survival in patients without cardiac tamponade. Immediate survival depends on the pericardial shock complication – postoperative low cardiac output syndrome (LCOS) or pericardial decompression syndrome (PDS). The indication for pericardial drainage depends on the quantity of pericardial fluid, presence of tamponade, associated pleural effusion and need for biopsy, offering the maximum possible benefit and safety for the patient.</p></sec></abstract>

IntroductionNeoplastic pericarditis may develop in any type of cancer, but it is found more frequently in lung cancer, breast cancer and lymphoma.MethodsWe studied 156 consecutive oncological patients presented with pericardial fluid between 2010 and 2015. Among them, 80 patients were stable, with no indication for pericardial drainage or biopsy, and 76 patients needed surgery to evacuate the pericardium and obtain biopsy.ResultsEchocardiography and computed tomography were essential in evaluating the topography of the pericardial fluid and the haemodynamic effect, and these investigations helped us choose the appropriate surgical procedure. We performed pericardiocentesis, subxiphoid pericardial drainage, left paraxifoidian pericardial drainage, pericardio-pleural window through intercostal video-assisted thoracic surgery (VATS) or through classical thoracic surgery. Twenty-three patients (14.7%) were admitted and treated for cardiac tamponade. The rate of recurrence after pericardial drainage was 3.89%. The immediate survival at 48 h was 97.3%.ConclusionLong-term survival in patients with malignancy and drained pericardial effusion is influenced mainly by the type of underlying malignant disease. We observed a better survival in patients without cardiac tamponade. Immediate survival depends on the pericardial shock complication – postoperative low cardiac output syndrome (LCOS) or pericardial decompression syndrome (PDS). The indication for pericardial drainage depends on the quantity of pericardial fluid, presence of tamponade, associated pleural effusion and need for biopsy, offering the maximum possible benefit and safety for the patient.

Management of neoplastic pericarditis – overview of 156 patients

University of Medicine and Pharmacy ‘Carol Davila’

Pneumologia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Managementul pericarditelor neoplazice – evaluarea a 156 de pacienti

IntroductionNeoplastic pericarditis may develop in any type of cancer, but it is found more frequently in lung cancer, breast cancer and lymphoma.MethodsWe...

Management of neoplastic pericarditis – overview of 156 patients

Article Category: Original Papers

Published Online: Dec 31, 2020

Page range: 97 - 102

DOI: https://doi.org/10.2478/pneum-2020-0020

Keywords
neoplastic pericardial effusion, cardiac tamponade, surgical pericardial drainage, video-assisted thoracic surgery (VATS), pericardial fenestration, subxiphoidian pericardial drainage, paraxiphoidian pericardial drainage

© 2020 Elena Jianu et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Management of neoplastic pericarditis – overview of 156 patients

Article Category: Original Papers

Published Online: Dec 31, 2020

Page range: 97 - 102

DOI: https://doi.org/10.2478/pneum-2020-0020

Keywordsneoplastic pericardial effusion, cardiac tamponade, surgical pericardial drainage, video-assisted thoracic surgery (VATS), pericardial fenestration, subxiphoidian pericardial drainage, paraxiphoidian pericardial drainage

© 2020 Elena Jianu et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
neoplastic pericardial effusion, cardiac tamponade, surgical pericardial drainage, video-assisted thoracic surgery (VATS), pericardial fenestration, subxiphoidian pericardial drainage, paraxiphoidian pericardial drainage