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Recurrent Malignant Pericardial Effusion Management: The Pericardio-Peritoneal Window
Antonio Mazzella1, Giovanni Caffarena1, Claudia Bardoni1
1Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy.
Journal of Clinical Medicine
|January 10, 2026
Summary
The pericardio-peritoneal window (PPW) is a safe and effective surgical option for managing malignant pericardial effusion (MPE) in patients with a good prognosis. For those with a less favorable outlook, pericardial drainage is recommended.
Area of Science:
- Oncology
- Cardiothoracic Surgery
- Palliative Care
Background:
- Malignant pericardial effusion (MPE) is a rare but challenging complication of solid tumors.
- Management of MPE often requires effective and safe therapeutic strategies.
Purpose of the Study:
- To evaluate the efficacy and long-term outcomes of the pericardio-peritoneal window (PPW) as a definitive treatment for MPE.
- To compare PPW with other management strategies for MPE.
Main Methods:
- Retrospective and prospective analysis of 44 patients undergoing PPW between 2010 and 2023.
- Data collected included surgical procedures, complications, mortality, and relapse rates.
- Associated procedures like videothoracoscopy and percutaneous drainage were noted.
Main Results:
- The 30-day mortality rate was 9%.
- The success rate for PPW, defined as absence of relapse requiring further intervention, was 95.5%.
- Recurrence of pericardial effusion occurred in 8 patients, with only 2 requiring further intervention.
Conclusions:
- Pericardio-peritoneal window (PPW) is a safe and effective definitive treatment for MPE in patients with a favorable short-term prognosis.
- Percutaneous pericardial drainage is a more appropriate therapy for patients with a less favorable prognosis.
Keywords:
lung cancermalignant pericardial effusionpericardial effusionpericardial metastasespericardio-peritoneal windowMore Related Videos
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