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Subxiphoid Mediastinoscopic Autonomous Double Fenestration.
Claudiu-Eduard Nistor1,2, Anca Pati Cucu1, Camelia Gavan1
1Thoracic Surgery Clinic, Spitalul Universitar de Urgenţă Militar Central Dr Carol Davila, Bucuresti, Romania.
The Thoracic and Cardiovascular Surgeon
|October 10, 2022
Summary
This study introduces a minimally invasive subxiphoid mediastinoscopic approach for frail patients with both pleural and pericardial effusions. The technique allows for rapid fluid drainage and tissue sampling, improving patient symptoms and offering diagnostic and therapeutic benefits.
Area of Science:
- Thoracic Surgery
- Minimally Invasive Procedures
- Diagnostic Imaging
Background:
- Frail patients with coexisting pleural and pericardial effusions require minimally invasive interventions.
- Neoplasia is a common comorbidity in these patients, complicating management.
- Existing methods may have a significant impact on patient status, necessitating safer alternatives.
Purpose of the Study:
- To present a novel subxiphoid mediastinoscopic autonomous double fenestration technique.
- To evaluate the diagnostic and therapeutic advantages of this approach.
- To demonstrate a method for rapid fluid evacuation and biopsy sampling in selected cases.
Main Methods:
- A subxiphoid incision was utilized for mediastinoscope insertion.
- Autonomous (simultaneous noncommunicating) double fenestration was performed.
- Pleural and pericardial fluids were evacuated, and tissue biopsies were obtained as needed.
Main Results:
- The subxiphoid mediastinoscopic approach significantly reduced operation duration.
- The technique allowed for effective fluid evacuation and symptom alleviation.
- Diagnostic and therapeutic benefits were observed in selected frail patients.
Conclusions:
- Subxiphoid mediastinoscopic autonomous double fenestration is a viable minimally invasive option for frail patients with combined effusions.
- This method offers advantages in terms of reduced invasiveness, speed, and symptom relief.
- It provides a valuable tool for both diagnosis and therapy in selected cases.
