Case Report

General Thoracic and Cardiovascular Surgery

, Volume 56, Issue 5, pp 229-232

Diaphragmatic repair of two cases of hepatic hydrothorax using video-assisted thoracoscopic surgery

  • Takayuki IbiAffiliated withDepartment of Thoracic Surgery, Nippon Medical School Hospital Email author 
  • , Kiyoshi KoizumiAffiliated withDepartment of Thoracic Surgery, Nippon Medical School Hospital
  • , Tomomi HirataAffiliated withDepartment of Thoracic Surgery, Nippon Medical School Hospital
  • , Iwao MikamiAffiliated withDepartment of Thoracic Surgery, Nippon Medical School Hospital
  • , Takao HisayoshiAffiliated withDepartment of Surgery, Mitaka Chuo Hospital
  • , Kazuo ShimizuAffiliated withDepartment of Thoracic Surgery, Nippon Medical School Hospital

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Abstract

Hepatic hydrothorax is defined as the presence of a significant pleural effusion that develops in a patient with cirrhosis of the liver who does not have underlying cardiac or pulmonary disease. There are few published case reports dealing with hepatic hydrothorax treated surgically because patients with hepatic hydrothorax have end-stage liver disease. Recently, we treated two patients with refractory hepatic hydrothorax by directly suturing the diaphragmatic defects during video-assisted thoracoscopic surgery (VATS). During surgery, the diaphragmatic defects were identified using abdominal insufflation of saline with indocyanine green or carbon dioxide. After suture closure using fibrin glue, both right pleural effusions were improved. The patients’ postoperative courses were uneventful, and they did not require a drainage tube when they were discharged.

Key words

Hepatic hydrothorax Video-assisted thoracoscopic surgery Diaphragmatic defect Diaphragmatic repair Pleural effusion