Thorac Cardiovasc Surg 2006; 54(1): 47-50
DOI: 10.1055/s-2005-865876
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Thoracoscopic Diaphragmatic Repair for Refractory Hepatic Hydrothorax: Application of Pleural Flap and Mesh Onlay Reinforcement

P.-M. Huang1 , S.-W. Kuo1 , J.-M. Lee1
  • 1Division of Thoracic Surgery, Department of Surgery and Traumatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Further Information

Publication History

Received May 3, 2005

Publication Date:
17 February 2006 (online)

Preview

Abstract

Background: Management of hepatic hydrothorax is difficult, and no radical treatment has been established. Based on accumulating evidence that diaphragmatic defects contribute to hepatic hydrothorax, we developed a diaphragmatic repair method for the management of this complex condition. Methods: From October 2003 to March 2005, 10 patients (age, 32 - 83 years; 6 men and 4 women) with refractory hepatic hydrothorax (Child-Pugh class B - C) underwent thoracoscopic pleura (n = 7) or mesh (n = 3) onlay reinforcement to repair the diaphragmatic defects on which this study focuses, and all patients have since been under follow-up in a prospective observation study. Results: After a mean of 7.7 months of follow-up examinations, no local recurrence occurred in all patients. Two patients died of hemorrhage from esophageal varices two months postoperatively. All patients had a better postoperative pulmonary function. Conclusion: The use of pleura and mesh onlay reinforcement of the diaphragm is an encouraging treatment for refractory hepatic hydrothorax.

References

Dr. Pei-Ming Huang

Division of Thoracic Surgery
Department of Surgery and Traumatology
National Taiwan University Hospital

No. 7, Chung-Shan S. Rd

Taipei 100

Taiwan

Phone: + 886223562557

Fax: + 88 62 23 22 28 90

Email: e370089@ha.mc.ntu.edu.tw