title: Subxiphoid video-pericardioscopy.
abstract: Pericardial effusion may be associated with many diseases, but sometimes its aetiology is not easy to elucidate. Subxiphoid video-pericardioscopy is useful for the study of the pericardial cavity. Through a subxiphoid approach, the pericardium is incised and a rigid (usually a video-mediastinoscope) or a flexible endoscope (flexible bronchoscope or flexible choledoscope) is inserted into the pericardial cavity. The inner surface of the parietal pericardium and the epicardium can be explored and biopsies can be taken under visual control. In addition, a subxiphoid pericardial window can be developed, and sclerosing agents instilled for pericardiodesis, if a malignant aetiology is confirmed. In case of pericardial effusion associated with lung cancer, video-pericardioscopy helps to confirm the absence or presence of pericardial tumour implant or infiltration, and to establish the resectability of the tumour. Other than transient arrhythmias during the procedure, video-pericardioscopy has no major complications. When compared with surgical pericardial drainage, video-pericardioscopy has higher sensitivity without specific risks. Rigid endoscopes are the best devices to explore the posterior and lateral pericardial surfaces, the pulmonary veins being the posterior limit of the exploration. Big anterior mediastinal masses and pericardial symphysis may render the exploration impossible.
authors.affiliation: Department of Thoracic Surgery, University Hospital Mutua Terrassa, University of Barcelona, Terrassa, Barcelona, Spain jctrujillo@icloud.com.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Trujillo-Reyes
authors.affiliation: Department of Thoracic Surgery, University Hospital Mutua Terrassa, University of Barcelona, Terrassa, Barcelona, Spain CIBERES Lung Cancer Group, Terrassa, Barcelona, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Rami-Porta
authors.affiliation: Department of Thoracic Surgery, University Hospital Mutua Terrassa, University of Barcelona, Terrassa, Barcelona, Spain.
authors.forename: Sergi Call
authors.initials: SC
authors.lastname: Caja
authors.affiliation: Department of Thoracic Surgery, University Hospital Mutua Terrassa, University of Barcelona, Terrassa, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Belda-Sanchis
mesh_terms: D004724:Endoscopy / Q000379:methods*; D006801:Humans; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D010491:Pericardial Window Techniques; D020535:Video-Assisted Surgery / Q000379:methods*
keywords: Pericardial effusion; Pericardiodesis; Video-pericardioscopy