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Eur J Cardiothorac Surg 2001;20:205-207
© 2001 Elsevier Science NL

Case report

Video-assisted thoracoscopic treatment for pleuroperitoneal communication in peritoneal dialysis

^a Department of Thoracic Surgery, Hokuriku Central Hospital, Toyama, Japan
^b Department of Surgery (1), Kanazawa University School of Medicine, Kanazawa, Japan
^c Department of Internal Medicine, Hokuriku Central Hospital, Toyama, Japan

Received 27 December 2000; received in revised form 20 March 2001; accepted 6 April 2001.

Corresponding author. Tel.: +81-76-265-2359; fax +81-76-222-6833
e-mail: ytsune{at}pop.m.kanazawa-u.ac.jp

Massive hydrothorax is an uncommon but well-recognized complication of continuous ambulatory peritoneal dialysis (CAPD). We performed a video-assisted thoracoscopic resection of the pleuro-peritoneal communication and pleurodesis in a patient with massive right hydrothorax secondary to CAPD. Histologically, the resected diaphragm was lacking in common tissue, tendons and skeletal muscle tissues, is displaced to fibrous connective tissue. These anatomic findings suggested that the cause of communication was congenital diaphragmatic change. Video-assisted thoracoscopic treatment facilitated efficient inspection and easy resection of the weak portion of the diaphragma in the case of pleuroperitoneal communication.

Key Words: Pleuroperitoneal communication • Continuous ambulatory peritoneal dialysis • Bleb • Video-assisted thoracic surgery • Pleurodesis

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