Laparoscopic management of right hydrothorax following peritoneal dialysis (PD)
Epublication WebSurg.com, Oct 2014;14(10). URL: http://websurg.com/doi/vd01en4282
Hydrothorax due to migration of dialysis fluid across the diaphragm and into the pleural space creates a serious complication of peritoneal dialysis (PD) but generally does not threaten life. The most current surgical option is the thoracoscopic approach. In this video, we propose an alternative treatment through an abdominal laparoscopic approach. Hydrothorax occurs rarely but represents a well-recognized complication of peritoneal dialysis (PD). The incidence of this condition ranges between 1.6% and 10% of peritoneal dialysis patients. Patients typically present with respiratory symptoms associated with reduction of dialysis fluid. The presence of pleuroperitoneal communication has been identified as the most common reason explaining hydrothorax in peritoneal dialysis. Conservative medical treatment is not effective. Surgical approaches range from open repair through a thoracotomy to video-assisted thoracoscopy surgery (VATS) with or without chemical or mechanical pleurodesis.