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Article: Video-assisted thoracoscopic talc pleurodesis is effective for maintenance of peritoneal dialysis in acute hydrothorax complicating peritoneal dialysis

TitleVideo-assisted thoracoscopic talc pleurodesis is effective for maintenance of peritoneal dialysis in acute hydrothorax complicating peritoneal dialysis
Authors
KeywordsCAPD
Hydrothorax
Pleurodesis
Talc poudrage
Issue Date2003
PublisherOxford University Press. The Journal's web site is located at http://ndt.oxfordjournals.org/
Citation
Nephrology Dialysis Transplantation, 2003, v. 18 n. 4, p. 804-808 How to Cite?
AbstractBackground. Acute, massive, unilateral hydrothorax is an uncommon but well-recognized complication of peritoneal dialysis. Its clinical course and treatment outcome after a recently advocated technique of video-assisted thoracoscopic (VATS) talc pleurodesis remains unclear. Methods and results. Between July 1998 and March 2002, among 475 CAPD patients in two regional hospitals in Hong Kong, nine patients (three men, six women, mean age 53 ± 12 years) developed acute hydrothorax due to pleuroperitoneal communication (R = 8, L = 1) within 5.8 ± 4.2 months (median, 5.2 m; range, 2 days to 11.6 months) of commencing peritoneal dialysis. Analysis of simultaneously obtained peritoneal and pleural fluid in all subjects only showed concordance in protein content (consistently < 4 g/l), while fluid glucose and lactate dehydrogenase levels were not comparable. The methylene blue test was negative (n = 4). Radionuclide scan (n = 6) and contrast CT peritoneography (CTP, n = 3) detected pleuroperitoneal communication in half and one-third of the patients, respectively. All patients underwent pleurodesis achieved by talc insufflation into the pleural cavity under VATS guidance. All patients were successfully returned to peritoneal dialysis. After a mean follow-up of 18.8 ± 12.5 months, hydrothorax recurred in one patient (at 7 months after pleurodesis), who was successfully treated by repeating the procedure. Conclusions. Hydrothorax complicating CAPD is more commonly right-sided, and tends to occur within the first year of starting peritoneal dialysis. Isotope scan and CTP are insensitive in diagnosing pleuroperitoneal communication. A low pleural fluid protein content is the most consistent biochemical finding. VATS talc pleurodesis is a safe and reliable treatment of choice that allows sustained continuation of CAPD with low recurrence rate.
Persistent Identifierhttp://hdl.handle.net/10722/77843
ISSN
2015 Impact Factor: 4.085
2015 SCImago Journal Rankings: 1.780
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTang, Sen_HK
dc.contributor.authorChui, WHen_HK
dc.contributor.authorTang, AWCen_HK
dc.contributor.authorLi, FKen_HK
dc.contributor.authorChau, WSen_HK
dc.contributor.authorHo, YWen_HK
dc.contributor.authorChan, TMen_HK
dc.contributor.authorLai, KNen_HK
dc.date.accessioned2010-09-06T07:36:21Z-
dc.date.available2010-09-06T07:36:21Z-
dc.date.issued2003en_HK
dc.identifier.citationNephrology Dialysis Transplantation, 2003, v. 18 n. 4, p. 804-808en_HK
dc.identifier.issn0931-0509en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77843-
dc.description.abstractBackground. Acute, massive, unilateral hydrothorax is an uncommon but well-recognized complication of peritoneal dialysis. Its clinical course and treatment outcome after a recently advocated technique of video-assisted thoracoscopic (VATS) talc pleurodesis remains unclear. Methods and results. Between July 1998 and March 2002, among 475 CAPD patients in two regional hospitals in Hong Kong, nine patients (three men, six women, mean age 53 ± 12 years) developed acute hydrothorax due to pleuroperitoneal communication (R = 8, L = 1) within 5.8 ± 4.2 months (median, 5.2 m; range, 2 days to 11.6 months) of commencing peritoneal dialysis. Analysis of simultaneously obtained peritoneal and pleural fluid in all subjects only showed concordance in protein content (consistently < 4 g/l), while fluid glucose and lactate dehydrogenase levels were not comparable. The methylene blue test was negative (n = 4). Radionuclide scan (n = 6) and contrast CT peritoneography (CTP, n = 3) detected pleuroperitoneal communication in half and one-third of the patients, respectively. All patients underwent pleurodesis achieved by talc insufflation into the pleural cavity under VATS guidance. All patients were successfully returned to peritoneal dialysis. After a mean follow-up of 18.8 ± 12.5 months, hydrothorax recurred in one patient (at 7 months after pleurodesis), who was successfully treated by repeating the procedure. Conclusions. Hydrothorax complicating CAPD is more commonly right-sided, and tends to occur within the first year of starting peritoneal dialysis. Isotope scan and CTP are insensitive in diagnosing pleuroperitoneal communication. A low pleural fluid protein content is the most consistent biochemical finding. VATS talc pleurodesis is a safe and reliable treatment of choice that allows sustained continuation of CAPD with low recurrence rate.en_HK
dc.languageengen_HK
dc.publisherOxford University Press. The Journal's web site is located at http://ndt.oxfordjournals.org/en_HK
dc.relation.ispartofNephrology Dialysis Transplantationen_HK
dc.rightsNephrology, Dialysis, Transplantation. Copyright © Oxford University Press.en_HK
dc.subjectCAPDen_HK
dc.subjectHydrothoraxen_HK
dc.subjectPleurodesisen_HK
dc.subjectTalc poudrageen_HK
dc.subject.meshAcute Diseaseen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAnalysis of Varianceen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshHydrothorax - etiology - therapyen_HK
dc.subject.meshKidney Failure, Chronic - diagnosis - therapyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPeritoneal Dialysis, Continuous Ambulatory - adverse effects - methodsen_HK
dc.subject.meshPleurodesis - methodsen_HK
dc.subject.meshProbabilityen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshRisk Assessmenten_HK
dc.subject.meshSampling Studiesen_HK
dc.subject.meshSeverity of Illness Indexen_HK
dc.subject.meshTalcen_HK
dc.subject.meshThoracoscopy - methodsen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.subject.meshVideo Recordingen_HK
dc.titleVideo-assisted thoracoscopic talc pleurodesis is effective for maintenance of peritoneal dialysis in acute hydrothorax complicating peritoneal dialysisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0931-0509&volume=18&spage=804&epage=808&date=2003&atitle=Video-assisted+Thoracoscopic+Talc+Pleurodesis+is+Effective+for+Maintenance+of+Peritoneal+Dialysis+in+Acute+Hydrothorax+Complicating+Peritoneal+Dialysisen_HK
dc.identifier.emailTang, S: scwtang@hku.hken_HK
dc.identifier.emailChan, TM: dtmchan@hku.hken_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.authorityTang, S=rp00480en_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1093/ndt/gfg042en_HK
dc.identifier.pmid12637652-
dc.identifier.scopuseid_2-s2.0-0037385593en_HK
dc.identifier.hkuros81125en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0037385593&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume18en_HK
dc.identifier.issue4en_HK
dc.identifier.spage804en_HK
dc.identifier.epage808en_HK
dc.identifier.isiWOS:000182139700027-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridTang, S=7403437082en_HK
dc.identifier.scopusauthoridChui, WH=7003524497en_HK
dc.identifier.scopusauthoridTang, AWC=7201845919en_HK
dc.identifier.scopusauthoridLi, FK=8219093900en_HK
dc.identifier.scopusauthoridChau, WS=13305781500en_HK
dc.identifier.scopusauthoridHo, YW=7402555047en_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK

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