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Updated: Jan 28, 2026

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Video-assisted thoracic surgery for pleuroperitoneal communication
Shota Mitsuboshi1, Hideyuki Maeda2, Masato Kanzaki1
1Department of Thoracic Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Background:
Hydrothorax due to pleuroperitoneal communication (PPC) is a rare complication of continuous ambulatory peritoneal dialysis (CAPD). Approximately 50% of the patients need to convert to hemodialysis.
Case Presentation:
A 65-year-old man with chronic renal failure due to membranoproliferative glomerulonephritis underwent CAPD. Seven months after starting CAPD, a chest X-ray showed a right hydrothorax. For performing radioscintigraphy, 99mTc-macro-aggregated albumin was administered into the peritoneal cavity with dialysate, and a leakage point of the dialysate into the right pleural cavity was detected. He was diagnosed with PPC and underwent video-assisted thoracic surgery (VATS). The hole was closed by direct suturing and reinforced by a pedicled latissimus dorsi muscle flap (LDM). The patient resumed CAPD 7 weeks later and had no recurrence of the right hydrothorax.
Conclusions:
VATS was a useful method for treating PPC. A pedicled LDM flap is an effective material for preventing the recurrence of PPC.
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