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[Videoscopic surgical treatment for the patient of pleuroperitoneal communication complicating CAPD]
H Hosoda1, Y Nishio, H Fujisaki
1Department of Thoracic Surgery, Hokushin General Hospital, Nakano, Japan.
A 60-year-old female presented in end-stage renal failure. She was introduced continuous ambulatory peritoneal dialysis in August 1997. After about six months, acute hydrothorax developed in her right side of the pleural cavity. Then she was obligated to give up CAPD because of repeated recurrence of hydrothorax. She wanted to return to CAPD for her life style. In November 1998, she came to our hospital to have a surgical treatment for her pleuroperitoneal communication. We performed video assisted thoracoscopic surgery. Using methylene blue containing dialysis solution through CAPD catheter, we found a bleb on the diaphragm that expanded gradually. We diagnosed that potion was pleuroperitoneal communication. The defect of diaphragm was directly closed with surgical stapler. Post-operative course was very favorable. She could restarted CAPD at 3 postoperative day, and discharged from our hospital after 5 days of operation. No recurrence of hydrothorax has been detected for a years after the surgical treatment.
A 60-year-old female presented in end-stage renal failure. She was introduced continuous ambulatory peritoneal dialysis in August 1997. After about six months, acute hydrothorax developed in her right side of the pleural cavity. Then she was obligated to give up CAPD because of repeated recurrence of hydrothorax. She wanted to return to CAPD for her life style. In November 1998, she came to our hospital to have a surgical treatment for her pleuroperitoneal communication. We performed video assisted thoracoscopic surgery. Using methylene blue containing dialysis solution through CAPD catheter, we found a bleb on the diaphragm that expanded gradually. We diagnosed that potion was pleuroperitoneal communication. The defect of diaphragm was directly closed with surgical stapler. Post-operative course was very favorable. She could restarted CAPD at 3 postoperative day, and discharged from our hospital after 5 days of operation. No recurrence of hydrothorax has been detected for a years after the surgical treatment.