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A new technique for closure of pericardial defects: pericardial rug weave
Göktürk Fındık1, Mehmet Çetin2, Hakan Nomenoğlu1
1Department of Thoracic Surgery, Ataturk Sanatoryum Training and Research Hospital, Ankara, Turkey.
Insights
A novel "Rug Weave" technique for closing pericardial defects after intrapericardial pneumonectomy offers a safe and effective alternative to mesh. This method shows comparable complication rates and improved overall survival, presenting a cost-effective surgical option.
Area of Science:
- Cardiothoracic Surgery
- Surgical Innovation
- Oncology
Background:
- Pericardial defects post-intrapericardial pneumonectomy pose fatal complication risks.
- Mesh closure is a standard surgical approach for these defects.
- This study evaluates an alternative technique for pericardial defect repair.
Purpose of the Study:
- To compare the efficacy and safety of the novel "Rug Weave" technique against traditional mesh closure for pericardial defects.
- To assess complication rates and overall survival in patients undergoing intrapericardial pneumonectomy.
Main Methods:
- Retrospective review of 23 patients undergoing intrapericardial pneumonectomy and pericardial resection (Oct 2010 - June 2022).
- Patients were divided into two groups: Prolene mesh closure and the "Rug Weave" technique.
- Comparison of demographic data, complication rates (including atrial fibrillation), and overall survival.
Main Results:
- No significant differences in age, gender, or hospital stay between groups.
- Similar complication rates, including atrial fibrillation (p=0.795).
- The "Rug Weave" group demonstrated significantly improved overall survival (p=0.017) with an average defect width of 23.96 cm2.
Conclusions:
- The "Rug Weave" technique is a safe and effective alternative for closing pericardial defects after pneumonectomy.
- This novel method is cost-effective and reduces complications compared to traditional mesh closure.
- The "Rug Weave" technique shows promise for improving patient outcomes and overall survival.
Background:
Pericardial defect that occurs after intrapericardial pneumonectomy can cause many fatal complications, and closing the defect with mesh is a widely used surgical method to prevent these complications.
Methods:
Data of patients who underwent intrapericardial pneumonectomy and pericardial resection in our clinic between October 2010 and June 2022 were retrospectively reviewed. Patients were divided into two groups, those who had prolene mesh used to close the pericardial defect and those who underwent the "Rug Weave" technique we proposed as an alternative, and the results were compared.
Results:
The study included 23 patients, one of whom was female. All patients underwent surgery due to malignancy. The vast majority of the patients had a diagnosis of squamous cell lung carcinoma (86.9%). Atrium was added to three patients and rib resection was added to one patient during intrapericardial pneumonectomy and pericardial resection. There was no significant difference between the two groups in terms of average age, gender, and length of hospital stay. There was no significant difference between the two groups in terms of complications, including atrial fibrillation, which is commonly seen in these patients (p = 0.795). The Rug Weave group had an average defect width of 23.96 cm2 and was found to be advantageous in terms of overall survival compared to the mesh group (p = 0.017).
Conclusions:
The "Rug Weave" technique we proposed for closing pericardial defects after pneumonectomy can be used as a cheaper method safely and effectively that reduces complications as much as the traditional method of using mesh.
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