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Communications to the Editor |

Treating Malignancy-Related Effusions FREE TO VIEW

Kenneth M. Frankel
Author and Funding Information

Baystate Medical Center Springfield, MA

Correspondence to: Kenneth M. Frankel, MD, FCCP, Division of Thoracic Surgery, Baystate Medical Center, Two Medical Center Dr, Suite 304, Springfield, MA 01107



Chest. 2003;123(5):1775. doi:10.1378/chest.123.5.1775
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Published online

To the Editor:

Wang et al1 describe an elegant minimally invasive double-balloon pericardiotomy procedure for large malignancy-related pericardial effusions, and appropriately point out that it has less morbidity and is just as effective as a conventional surgical subxiphoid pericardial window; however, they do not address simple pericardial drainage and sclerosis, an even less invasive, lower-cost procedure, just as effective and with considerably less morbidity than either a surgical window or a balloon pericardiotomy.

Pericardiocentesis and intrapericardial sclerosis has essentially replaced surgical drainage in many thoracic surgical oncologic practices.24 Without addressing this simpler procedure, I do not think their conclusion that double-balloon pericardiotomy is “the treatment of choice in this population” is justified.56

References

Wang, HJ, Hsu, KL, Chiang, FT, et al (2002) Technical and prognostic outcomes of double-balloon pericardiotomy for large malignancy- related pericardial effusions.Chest122,893-899. [PubMed] [CrossRef]
 
Maher, EA, Shepherd, FA, Todd, TJR Pericardial sclerosis as the primary management of malignant pericardial effusion and cardiac tamponade.J Thorac Cardiovasc Surg1996;112,637-643. [PubMed]
 
Girardi, LN, Ginsberg, RJ, Burt, ME Pericardiocentesis and intrapericardial sclerosis: effective therapy for malignant pericardial effusions.Ann Thorac Surg1997;64,1422-1428. [PubMed]
 
Anderson, TM, Ray, CW, Nwogu, CE, et al Pericardial catheter sclerosis versus surgical procedures for pericardial effusions in cancer patients.J Cardiovasc Surg2001;42,415-419
 
Frankel, KM Management of dyspnea at the end of life [letter]. J Am Coll Surg. 2002;;195 ,.:436. [PubMed]
 
Monsenthal, AC, Lee, KF Reply [letter]. J Am Coll Surg. 2002;;195 ,.:437. [PubMed]
 

Figures

Tables

References

Wang, HJ, Hsu, KL, Chiang, FT, et al (2002) Technical and prognostic outcomes of double-balloon pericardiotomy for large malignancy- related pericardial effusions.Chest122,893-899. [PubMed] [CrossRef]
 
Maher, EA, Shepherd, FA, Todd, TJR Pericardial sclerosis as the primary management of malignant pericardial effusion and cardiac tamponade.J Thorac Cardiovasc Surg1996;112,637-643. [PubMed]
 
Girardi, LN, Ginsberg, RJ, Burt, ME Pericardiocentesis and intrapericardial sclerosis: effective therapy for malignant pericardial effusions.Ann Thorac Surg1997;64,1422-1428. [PubMed]
 
Anderson, TM, Ray, CW, Nwogu, CE, et al Pericardial catheter sclerosis versus surgical procedures for pericardial effusions in cancer patients.J Cardiovasc Surg2001;42,415-419
 
Frankel, KM Management of dyspnea at the end of life [letter]. J Am Coll Surg. 2002;;195 ,.:436. [PubMed]
 
Monsenthal, AC, Lee, KF Reply [letter]. J Am Coll Surg. 2002;;195 ,.:437. [PubMed]
 
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