A New Intraoperative Method for Detecting Fistulas in Patients With Peritoneal Dialysis-Associated Pleuroperitoneal...

Patients undergoing peritoneal dialysis may experience pleuroperitoneal communication caused by increased intraabdominal pressure from dialysis fluid. Even if the fistula is surgically closed, recurrence is common, sometimes requiring a switch to hemodialysis. One cause of recurrence is the difficulty in identifying the microfistula intraoperatively. During thoracoscopic fistula closure in the patient described in this case report, indigo carmine was used to identify the fistula and indocyanine green was then used to confirm closure. As a result of using this efficient and reliable method, pleuroperitoneal communication has not recurred for 2 months postoperatively.