The safety and efficiency of pericardial window by using uniportal video-assisted thoracoscopic surgery for the treatment of pericardial effusion: A single-center experience

INTRODUCTION: Pericardial window (PW) is a surgical procedure in which a part of the pericardium is removed so that the effusion can flow into the chest cavity. Our study aims to analyze a series of patients with chronic recurrent and/or large pericardial effusions who underwent single-port video-assisted thoracoscopic surgery (VATS)-PW opening. The uniportal method seems to be a better option because it is performed with small cosmetic incisions and is less painful.
METHODS: Thirty-six patients were referred to our clinic with recurrent, chronic, and/or large PE between March 2019 and May 2022. All patients were analyzed for gender, age, body mass index (BMI), symptom, operation side, discharge time, complications, and pathologic specimens.
RESULTS: Of the 35 patients, 25 (71.4%) were male, 10 (28.6%) were female, and the mean age was 60.1±15.4 years. The left side was preferred for 28 patients (80%) and the right for 7 (20%). The median BMI was 25.5 kg/m² (24.0–28.1). The median day of stay in our clinic and/or referred clinic where they are followed up due to comorbidities was 1 (1–2). Four patients (11.4%) who were previously diagnosed with malignancy and whose pericardial biopsy was compatible with the primary disease died within the 1st month postoperatively. The mortalities were not attributed to the pericardial procedure.
DISCUSSION AND CONCLUSION: PW opening using uniportal VATS seems to be a safe method for patients with PE without needing one-lung ventilation. In addition, uniportal VATS can be considered the first surgical option in obese patients.