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Thorac Cardiovasc Surg 2023; 71(01): 76-78
DOI: 10.1055/s-0042-1757177
How to Do It

Subxiphoid Mediastinoscopic Autonomous Double Fenestration

Claudiu-Eduard Nistor
1   Thoracic Surgery Clinic, Spitalul Universitar de Urgenţă Militar Central Dr Carol Davila, Bucuresti, Romania
2   Cardio-Thoracic Pathology, Carol Davila University of Medicine and Pharmacy Faculty of General Medicine, Bucuresti, Romania
,
Anca Pati Cucu
1   Thoracic Surgery Clinic, Spitalul Universitar de Urgenţă Militar Central Dr Carol Davila, Bucuresti, Romania
,
Camelia Gavan
1   Thoracic Surgery Clinic, Spitalul Universitar de Urgenţă Militar Central Dr Carol Davila, Bucuresti, Romania
,
Adrian Ciuche
1   Thoracic Surgery Clinic, Spitalul Universitar de Urgenţă Militar Central Dr Carol Davila, Bucuresti, Romania
2   Cardio-Thoracic Pathology, Carol Davila University of Medicine and Pharmacy Faculty of General Medicine, Bucuresti, Romania
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Abstract

The coexistence of pleural and pericardial effusions in frail patients with or without confirmed neoplasia necessitates the use of a minimally invasive technique that has a minor impact on the patient's general status and allows for fast fluid evacuation and biopsy sampling if necessary. We present a subxiphoid mediastinoscopic autonomous (simultaneous noncommunicating) double fenestration approach for these patients with both diagnostic and therapeutic advantages in selected cases. Using the mediastinoscope alone through the subxiphoid incision can considerably reduce the duration of operation, allow for fluid evacuation, and significantly alleviate the patient's symptoms. This method enables the sampling of pleural and pericardial fluids and targeted tissue, if necessary.

Keywords

pleuropericardial effusion - subxiphoid mediastinoscopic approach - autonomous double fenestration

Informed Consent Statement

Written informed consent has been obtained from the patients to publish this paper.




Publication History

Received: 10 May 2022

Accepted: 15 August 2022

Article published online:
10 October 2022

© 2022. Thieme. All rights reserved.

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