title: Diaphragmatic repair of two cases of hepatic hydrothorax using video-assisted thoracoscopic surgery.
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.
authors.affiliation: Department of Thoracic Surgery, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan. t-ibi@nms.ac.jp
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ibi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Koizumi
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hirata
authors.forename: Iwao
authors.initials: I
authors.lastname: Mikami
authors.forename: Takao
authors.initials: T
authors.lastname: Hisayoshi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003964:Diaphragm / Q000000981:diagnostic imaging / Q000601:surgery*; D004322:Drainage; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006801:Humans; D006876:Hydrothorax / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D007327:Insufflation; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D013536:Suture Techniques; D020775:Thoracic Surgery, Video-Assisted; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives