Surgical properties and survival of a pericardial window via left minithoracotomy for benign and malignant pericardial tamponade in cancer patients

World J Surg Oncol. 2012 Jun 28:10:123. doi: 10.1186/1477-7819-10-123.

Abstract

Background: Surgical drainage is a rapid and effective treatment for pericardial tamponade in cancer patients. We aimed to investigate the effectiveness of pericardial window formation via mini-thoracotomy for treating pericardial tamponade in cancer patients, and to evaluate clinical factors affecting long-term survival.

Methods: Records of 53 cancer patients with pericardial tamponade treated by pericardial window formation between 2002 and 2008 were examined. Five patients were excluded due to insufficient data. Kaplan-Meier and Cox regression analysis were used for analysis.

Results: Forty-eight patients (64.7% male), with a mean age of 55.20 ± 12.97 years were included. Patients were followed up until the last control visit or death. There was no surgery-related mortality and the 30-day mortality rate was 8.33%; all died during postoperative hospitalization. Morbidity rate was 18.75%. Symptomatic recurrence rate was 2.08%. Cancer type and nature of the pericardial effusion were the major factors determining long-term survival (P <0.001 and P <0.004, respectively).Overall median survival was 10.41 ± 1.79 months. One- and 2-year survival rates were 45 ± 7% and 18 ± 5%, respectively.

Conclusion: Pericardial window creation via minithoracotomy was proven to be a safe and effective approach in surgical treatment of pericardial tamponade in cancer patients. Cancer type and nature of pericardial effusion were the main factors affecting long-term survival.

MeSH terms

  • Adult
  • Aged
  • Cardiac Tamponade / etiology
  • Cardiac Tamponade / mortality*
  • Cardiac Tamponade / surgery
  • Drainage
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Pericardial Effusion / etiology
  • Pericardial Effusion / mortality*
  • Pericardial Effusion / surgery
  • Pericardial Window Techniques*
  • Postoperative Complications*
  • Prognosis
  • Recurrence
  • Survival Rate
  • Thoracotomy*