The pericardio-peritoneal window achieved a 95.5% success rate in preventing pericardial relapse requiring further procedures in patients with malignant pericardial effusion.
Does pericardio-peritoneal window creation prevent recurrent malignant pericardial effusion in patients with solid tumors?
Pericardio-peritoneal window creation is a safe and effective definitive therapeutic strategy for resolving malignant pericardial effusion, with a high success rate in preventing relapse requiring further procedures.
Absolute Event Rate: 0% vs 0%
Introduction: Malignant pericardial effusion (MPE) represents a relatively rare complication in various types of solid tumors. Its management is often challenging. One solution can be represented by surgical approaches, including a pericardio-peritoneal window (PPW), which allows draining the fluid into the abdominal cavity. The aim of this study is to investigate the efficacy and long-term outcomes of the PPW procedure as a definitive therapeutic strategy for MPE. Materials and methods: We retrospectively and prospectively observed pre-, peri-, and postoperative data of patients undergoing pericardio-peritoneal window creation from 2010 to December 2023 at the European Institute of Oncology (IEO), including the surgical procedures needed, total and specific postoperative complications, 30-day mortality rate, relapse rate, and the treatment of possible relapses. Results: A total of 44 consecutive patients underwent a pericardio-peritoneal window. In 28 patients (63.8%) PPW was associated with mono or bilateral videothoracoscopy for pleural biopsies/talc poudrage. In 23 cases, pre-operative percutaneous pericardial drainage (usually 1–2 days before surgery) was performed. No intraoperative deaths were observed. The 30-day mortality was 9% (four patients). We observed pericardial effusion recurrence in three patients at two months and in five patients at six months. In only two cases we treated this condition because of a pre-tamponade condition, treated by percutaneous pericardial drainage. The success rate of the PPW regarding pericardial relapse requiring further procedures was 95.5%. Conclusions: Patients presenting with a favorable short-term prognosis benefit from the pericardio-peritoneal window as a safe and effective method for resolving malignant pericardial effusion. Conversely, pericardial drainage is recommended as the most appropriate therapy for those with a less favorable prognosis.
Mazzella et al. (Mon,) reported a other. The pericardio-peritoneal window achieved a 95.5% success rate in preventing pericardial relapse requiring further procedures in patients with malignant pericardial effusion.