Comparison of open subxiphoid pericardial drainage with percutaneous catheter drainage for symptomatic pericardial effusion

摘要: Abstract Background The optimal therapy for symptomatic pericardial effusions remains controversial. This paper compares outcomes after the two most commonly used techniques, percutaneous catheter drainage and operative subxiphoid drainage. Methods We performed a 5-year retrospective, single-institution study to analyze either or open effusions. Results Symptomatic in 246 patients were treated by pericardiotomy tube (n = 150) 96). Drainage duration, total volume, duration of follow-up (2.6 years) similar both groups. Effusions classified malignant 79 (32%) benign 167 (68%) patients. No direct procedural mortality occurred, but hospital was 16 (10.7%) group 22 (22.9%) ( p 0.01) survival rate 51% versus 45% group, despite greater percentage having preoperative diagnosis (35% 28%). recurred 16.5% compared with 4.6% 0.002), sclerosis did not appear reduce recurrence rates (10.7% 15.6% without; > 0.05). malignancy confirmed 27 (59%) procedures on known malignancy. In cytologic pathologic evaluation specimen revealed 32 52 (62%) Conclusions Subxiphoid can be safely; however, death occurs from underlying disease. Open biopsy appears decrease does improve diagnostic accuracy over cytology alone.