A Case of Video-Assisted Thoracic Surgical Management of Recurrent Pericardial Effusion

Video-assisted thoracic surgery (VATS) is replasing standard thoracotomy in the management of many thoracic diseases. VATS that is superior to thoracotomy in terms of less surgical invasion and postoperative pain has been performed at our department from November 1, 1992. Recently we employed VATS for performing a pericardial resection in a 56-year-old man with recurrent pericardial effusion. There was a previous history of undergoing radiation therapy for a malignant lymphoma of the mediastinum 15 years before. The surgical procedure was performed under general anesthesia with doublelumen endobronchial intubation and placed in a lateral ducubitus position. After the thoracoscope was introduced, the phrenic nerve was identified and adequate pericardial resections (6×5cm, 4×2cm) were done. The pathological findings of resected specimens showed chronic inflammatory change without malignancy. No recurrence of pericardial effusion has been seen. The patients has been well 5 months postoperatively. In conclusion, VATS is minimally invasive techniques for the treatment of thoracic diseases, and adequate pericardial resection for pericardial effusion is a favorable indication for VATS.