Our Summary

This research paper is about a study that was carried out to see the long-term results of a procedure called video-assisted thoracoscopic (VATS) pericardiectomy. This procedure is used to treat a condition called chronic or recurrent pericardial effusion, which is often associated with cancer.

The study looked at 29 patients who had the procedure. Some of these patients had cancer and some did not. The researchers noted how well the patients were doing before the operation, and then looked at how they were doing afterwards.

They found that the patients’ health improved significantly after the procedure. Those who did not have cancer survived for a lot longer (around 14.7 years on average) than those who did have cancer (around 5.5 months on average). Patients with breast cancer survived for about 7 months on average, while patients with other types of cancer survived for about 2 months on average.

The researchers also found that the procedure was generally safe, with most patients having no problems afterwards. Importantly, the condition did not come back in any of the patients.

The study concluded that this procedure can help people with non-cancerous pericardial effusion live for a long time. However, for people with cancerous pericardial effusion, the outcome is not as good, though their quality of life can still be improved. The researchers stress that it’s important to carefully choose who gets the procedure because there is a risk of death shortly after the operation.

FAQs

  1. What is a VATS pericardiectomy and when is it performed?
  2. What were the survival times after VATS pericardiectomy for patients with and without malignancies?
  3. How does a patient’s preoperative performance status (PS) affect the outcomes of VATS pericardiectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pericardiectomy is to carefully consider the underlying cause of the pericardial effusion, as nonmalignant cases tend to have better long-term outcomes compared to malignant cases. It is important to undergo a thorough evaluation and discuss the potential risks and benefits of the procedure with your healthcare provider before proceeding with surgery. Additionally, maintaining good postoperative care and regular follow-up appointments can help prevent recurrent pericardial effusions.

Suitable For

Patients who are typically recommended for pericardiectomy are those with chronic or recurrent pericardial effusion, particularly those with nonmalignant pericardial effusion. Patients with malignant pericardial effusion may also be considered for pericardiectomy, but the prognosis is generally poorer. It is important to carefully select patients for the procedure based on factors such as performance status and overall health.

Timeline

  • Preoperative: Patients with chronic or recurrent pericardial effusion, often associated with malignant disease, undergo evaluation and assessment of performance status (PS) scores. A decision is made to proceed with video-assisted thoracoscopic (VATS) pericardiectomy.

  • Pericardiectomy procedure: The VATS pericardiectomy is performed, with careful selection of patients. Intraoperative mortality may occur in some cases.

  • Postoperative: Patients experience significant improvement in PS scores after the procedure. Most cases have uneventful postoperative courses, with no recurrent pericardial effusions observed. Long-term survival is expected in cases of nonmalignant pericardial effusion, while malignant pericardial effusion has a poor prognosis. Patients with malignancy may experience shorter survival times, but most maintain good PS.

Overall, the timeline includes preoperative evaluation, the pericardiectomy procedure, and postoperative monitoring for recurrence and long-term outcomes.

What to Ask Your Doctor

  1. What is the success rate of VATS pericardiectomy in treating chronic or recurrent pericardial effusion?
  2. How long is the recovery period after undergoing VATS pericardiectomy?
  3. What are the potential risks and complications associated with VATS pericardiectomy?
  4. How often will follow-up appointments be needed after the procedure?
  5. Are there any lifestyle changes or restrictions that need to be followed after VATS pericardiectomy?
  6. How does VATS pericardiectomy compare to other treatment options for pericardial effusion?
  7. What is the expected long-term outcome for patients with malignancy-related pericardial effusion after VATS pericardiectomy?
  8. Are there any specific criteria or factors that determine whether a patient is a good candidate for VATS pericardiectomy?
  9. What is the typical prognosis for patients with nonmalignant pericardial effusion after undergoing VATS pericardiectomy?
  10. Are there any additional tests or treatments that may be necessary before or after VATS pericardiectomy?

Reference

Authors: Mizukami Y, Ueda N, Adachi H, Arikura J, Kondo K. Journal: Ann Thorac Cardiovasc Surg. 2017 Dec 20;23(6):304-308. doi: 10.5761/atcs.oa.17-00046. Epub 2017 Aug 9. PMID: 28794388