Pericardial tamponade: an unusual complication of lobectomy for lung cancer

McLean, Ronald H; Parandian, Bahman; Nam, Myung Hee

doi:10.1016/s0003-4975(98)01245-4

Cited by 23 publications

(16 citation statements)

References 6 publications

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“…To date only few cases have been described. In the literature the etiology of intrapericardial bleeding was attributable to pre-existing conditions or related to surgical procedure [1][2][3]. The present case illustrates another of this uncommon complication, wherein the exact mechanism of injury remained undefined.…”

Section: Introductionmentioning

confidence: 80%

“…Some Authors reported cases of intrapericardial bleeding resulting from retraction of the dissected pulmonary vein in the pericardial sac or intraoperative transection of bronchial artery arising from the intrapericardial space [1,2]. Eventhough lymph nodal dissection was not performed because of the benigne nature of the disease, we suspected bleeding could have been originated from the mediastinum or transected lobar hilar structures.…”

Section: Commentmentioning

confidence: 97%

See 1 more Smart Citation

Hemopericardium after Lung Lobectomy

Aless¹,

ro²,

Piergiorio³

et al. 2016

J Pulm Respir Med

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Section: Introductionmentioning

confidence: 80%

Section: Commentmentioning

confidence: 97%

Hemopericardium after Lung Lobectomy

Aless¹,

ro²,

Piergiorio³

et al. 2016

J Pulm Respir Med

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“…In these cases, the reported causes of pericardial effusion include residual undrained blood and the prevention of lymphatic drainage after mediastinal dissection. 8,9 It is difficult to obtain a correct diagnosis of pericardial tumor. In this report, we failed to consider IgG4-related disease as a differential diagnosis before surgical biopsy and surgical resection was required to make a correct diagnosis based on a histopathological examination.…”

Section: Discussionmentioning

confidence: 99%

Pericardial immunoglobulin G4‐related inflammatory pseudotumor after right upper lobectomy for lung cancer

et al. 2020

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A 75-year-old woman underwent thoracoscopic right upper lobectomy for lung cancer. A histopathological examination showed adenocarcinoma, pT1aN0M0 stage IA1. At six months after surgery, chest computed tomography (CT) revealed pericardial nodules that had not been detected before pulmonary resection. Postoperative CT performed two months later revealed that the nodules were growing and F 18 fluorodeoxyglucose-positron emission tomography showed a maximum standardized uptake of 9.87. Blood tests revealed no elevated tumor markers, with the exception of a mildly elevated interleukin-2. Based on the above results, thoracoscopic biopsy was performed due to the suspected recurrence of lung cancer or malignant lymphoma. The histopathological examination of the nodule revealed immunoglobulin G4 (IgG4)-related inflammatory pseudotumor. The serum IgG4 levels were elevated (358 mg/dL, normal: 4.5-117.0 mg/dL). No additional treatment was required because all nodules were observed to have disappeared naturally on a follow-up CT scan performed two months after the surgical biopsy. The patient has been followed-up for two years without recurrence. Key points Significant findings of the study: We report a case of pericardial immunoglobulin G4-related inflammatory pseudotumor that appeared after right upper lobectomy for lung cancer, and which naturally disappeared without any treatment. What this study adds: There was an immunoglobulin G4-related inflammatory pseudotumor which appeared as multiple nodules in the pericardial space, and this should be kept in mind when considering the differential diagnosis of intrapericardial nodules.

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“…Subdiaphragmatic injury to both liver and spleen have been described secondary to trocar placement during these procedures as well (27). Rare cases of pericardial tamponade have been reported secondary to bleeding and retraction of vessels into the pericardium, and direct injury to coronary vessels (28)(29)(30)(31).…”

Section: Vats Lung Resections: Intraoperative Bleeding and Other Compmentioning

confidence: 99%

Prevention and management of intraoperative crisis in VATS and open chest surgery: how to avoid emergency conversion

Safdie¹,

Sanchez²,

Sarkaria³

2017

J. Vis. Surg.

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Video assisted thoracic surgery (VATS) has become a routinely utilized approach to complex procedures of the chest, such as pulmonary resection. It has been associated with decreased postoperative pain, shorter length of stay and lower incidence of complications such as pneumonia. Limitations to this modality may include limited exposure, lack of tactile feedback, and a two-dimensional view of the surgical field. Furthermore, the lack of an open incision may incur technical challenges in preventing and controlling operative misadventures leading to major hemorrhage or other intraoperative emergencies. While these events may occur in the best of circumstances, prevention strategies are the primary means of avoiding these injuries. Unplanned conversions for major intraoperative bleeding or airway injury during general thoracic surgical procedures are relatively rare and often can be avoided with careful preoperative planning, review of relevant imaging, and meticulous surgical technique. When these events occur, a pre-planned, methodical response with initial control of bleeding, assessment of injury, and appropriate repair and/ or salvage procedures are necessary to maximize outcomes. The surgeon should be well versed in injuryspecific incisions and approaches to maximize adequate exposure and when feasible, allow completion of the index operation. Decisions to continue with a minimally invasive approach should consider the comfort and experience level of the surgeon with these techniques, and the relative benefit gained against the risk incurred to the patient. These algorithms may be expected to shift in the future with increasing sophistication and capabilities of minimally invasive technologies and approaches. hemorrhage within moments. While these events may occur in the best of circumstances, prevention strategies are the primary means of avoiding these injuries. When they do occur, premeditated and expedited intervention is the key to rescue (1). The current report focuses on the prevention and management of these emergency bleeding events in VATS pulmonary resections. Preoperative radiologic assessment of vascular and anatomic variationRigorous preoperative evaluation of fitness of surgery is a key component of any operative assessment. Preoperative identification and awareness of case-specific and patientspecific risk factors may help prevent hemorrhagic complications in most lung resections. These factors include body habitus, preoperative chemotherapy and radiation, bleeding diatheses including medical anticoagulants, previous thoracic surgery, lymph node calcification and/or granulomatous disease, tumor size and location.Computed chest tomography has become a standard of care in virtually all cases considered for major pulmonary resection. These high resolution scans, often available with three dimensional reconstruction, can provide valuable opportunities to identify standard and anomalous vascular variations prior to surgery in greater than 95% of cases (2-6). Imaging may also identify cal...

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Pericardial tamponade: an unusual complication of lobectomy for lung cancer

Cited by 23 publications

References 6 publications

Hemopericardium after Lung Lobectomy

Hemopericardium after Lung Lobectomy

Pericardial immunoglobulin G4‐related inflammatory pseudotumor after right upper lobectomy for lung cancer

Prevention and management of intraoperative crisis in VATS and open chest surgery: how to avoid emergency conversion

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