Background: In this study we evaluated the importance of videoassisted thoracoscopic surgery (VATS) in the daily surgical practice by comparing the clinical results of patients with pericardial effusions who underwent classical anterior thoracotomy with thoracoscopic pericardial window. We also compared and discussed the potential advantages and possible weaknesses of thoracoscopic surgery versus the classical techniques with data available from the literature.

Methods: Between January 2006 and December 2009, 94 patients diagnosed with pericardial effusion and/or tamponade who did not respond to previous medical treatments or who had a recurrence after multiple pericardiosynthesis procedures underwent surgical partial pericardial resection using surgical methods. Of these 94 patients 50 were operated on using pericardiectomy with VATS and 44 patients were operated on via anterolateral thoracotomy. These cases were evaluated with respect to age and gender distribution, etiology, operation type, operation time, quality and amount of the drained pericardial fluid, duration of intensive care unit (ICU) stay, chest tube drainage, duration of hospitalization, pathological diagnosis, complications, recurrence, cost, morbidity and mortality.

Results: Significant differences were found in patients with or without malignancy. In malignant cases; no statistically significant differences were found with respect to age, gender, recurrence, operation times, or amount of drainage by the surgical technique (p>0.05). Statistically significant differences were found in favor of VATS with respect to duration of ICU stay, duration of hospitalization, drain extraction time and costs of the surgical technique (p<0.01). No statistically significant differences were found with respect to age, gender, recurrence, operation times, duration of ICU stay, amount of drainage and costs of the surgical technique in patients with benign pathology (p>0.05). Statistically significant differences were found in favor of VATS with respect to duration of hospitalization and drain extraction time by the surgical technique in this patients (p<0.01).

Conclusion: Video-assisted pericardiectomy is an effective technique for pericardial drainage and biopsy. It allows the surgeon to accomplish a pericardial resection for effective drainage while avoiding the complications of classic surgical procedures and concomitant pleural and pulmonary disorders may be managed simultaneously.

Keywords : Pericardiectomy; surgery; thoracic; video-assisted thoracoscopic surgery