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Subxiphoid pericardiotomy in the diagnosis and management of large pericardial effusions associated with malignancy.

Publication ,  Journal Article
Campbell, PT; Van Trigt, P; Wall, TC; Kenney, RT; O'Connor, CM; Sheikh, KH; Kisslo, JA; Baker, ME; Corey, GR
Published in: Chest
April 1992

To determine the safety, diagnostic value, and clinical outcome of patients with malignancy undergoing subxiphoid pericardiotomy for large pericardial effusions, we prospectively studied 25 consecutive patients with malignancy and new, large pericardial effusions diagnosed by echocardiography. Twenty-two of the 25 operations were done under local anesthesia, and no patient died at surgery. Pericardial fluid cytology revealed malignant cells in 11 patients (44 percent), while tumor was seen in only five (45 percent) of these 11 patients on pathologic examination. The remaining 14 patients showed no evidence of pericardial invasion with tumor. Evidence of intrathoracic disease by CT or MRI scanning, tamponade, a sanguineous pericardial fluid character, and an elevated serum and pericardial fluid lactate dehydrogenase level all were suggestive of malignant invasion of the pericardium. All 25 patients were followed at least 12 months postoperatively. Effusions recurred in three patients (12 percent), and one patient required reoperation. Overall mortality was 72 percent with a 91 percent (10 of 11) mortality for those with malignant effusions and a 57 percent (8 of 14) mortality for those with nonmalignant effusions. Diagnostically, subxiphoid pericardiotomy has little advantage over examination of pericardial fluid alone in this group of patients. Therapeutically, however, it is a low morbidity procedure which is safe and effective in treating patients with malignancy and large pericardial effusions.

Duke Scholars

Published In

Chest

DOI

ISSN

0012-3692

Publication Date

April 1992

Volume

101

Issue

4

Start / End Page

938 / 943

Location

United States

Related Subject Headings

  • Xiphoid Bone
  • Respiratory System
  • Reoperation
  • Recurrence
  • Prospective Studies
  • Pericardiectomy
  • Pericardial Effusion
  • Neoplasms
  • Humans
  • Echocardiography
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Campbell, P. T., Van Trigt, P., Wall, T. C., Kenney, R. T., O’Connor, C. M., Sheikh, K. H., … Corey, G. R. (1992). Subxiphoid pericardiotomy in the diagnosis and management of large pericardial effusions associated with malignancy. Chest, 101(4), 938–943. https://doi.org/10.1378/chest.101.4.938
Campbell, P. T., P. Van Trigt, T. C. Wall, R. T. Kenney, C. M. O’Connor, K. H. Sheikh, J. A. Kisslo, M. E. Baker, and G. R. Corey. “Subxiphoid pericardiotomy in the diagnosis and management of large pericardial effusions associated with malignancy.Chest 101, no. 4 (April 1992): 938–43. https://doi.org/10.1378/chest.101.4.938.
Campbell PT, Van Trigt P, Wall TC, Kenney RT, O’Connor CM, Sheikh KH, et al. Subxiphoid pericardiotomy in the diagnosis and management of large pericardial effusions associated with malignancy. Chest. 1992 Apr;101(4):938–43.
Campbell, P. T., et al. “Subxiphoid pericardiotomy in the diagnosis and management of large pericardial effusions associated with malignancy.Chest, vol. 101, no. 4, Apr. 1992, pp. 938–43. Pubmed, doi:10.1378/chest.101.4.938.
Campbell PT, Van Trigt P, Wall TC, Kenney RT, O’Connor CM, Sheikh KH, Kisslo JA, Baker ME, Corey GR. Subxiphoid pericardiotomy in the diagnosis and management of large pericardial effusions associated with malignancy. Chest. 1992 Apr;101(4):938–943.
Journal cover image

Published In

Chest

DOI

ISSN

0012-3692

Publication Date

April 1992

Volume

101

Issue

4

Start / End Page

938 / 943

Location

United States

Related Subject Headings

  • Xiphoid Bone
  • Respiratory System
  • Reoperation
  • Recurrence
  • Prospective Studies
  • Pericardiectomy
  • Pericardial Effusion
  • Neoplasms
  • Humans
  • Echocardiography