Novosti
Khirurgii
This journal is
indexed in Scopus



Year 2017 Vol. 25 No 2

CASE REPORTS

DOI: https://dx.doi.org/10.18484/2305-0047.2017.2.194   |  

V.L. TIMOSHOK, A.A. SVIRSKY, E.V. KOROLKOVA, K.V. DROZDOVSKY, A.M. MAKHLIN, V.V. DEDOVICH, A.L. SHALKEVICH, V.V. DROZDOVSKAYA

THE FIRST CASE OF SUCCESSFUL THORACOSCOPIC PERICARDECTOMY IN THE REPUBLIC OF BELARUS IN INFANT AGED 1,5 MONTHS WITH FIBRINOPURULENT PERICARDITIS

SE "Republican Research and Practical Center for Pediatric Surgery"
Minsk,
The Republic of Belarus

The article describes the first successful thoracoscopic pericardectomy performed in the Republic of Belarus in the infant aged 1,5 months due to the acute fibrinopurulent exudative pericarditis. Pericarditis is the inflammation of the serous heart membrane. According to pericarditis clinical signs the acute, subacute and chronic course has been defined. Depending on the inflammatory nature of pericarditis the fibrinous and exudative pericarditis with the presence of purulent, fibrinopurulent, serous, serous-fibrinous and hemorrhagic effusion has been determed. Surgical treatment is indicated in case of a life-threatening condition and development of the cardiac tamponade, in purulent and constrictive pericarditis. Issues related to a method and size of surgical intervention in acute purulent pericarditis in children are discussed in this paper. The infant was performed the subtotal thoracoscopic pericardectomy with good clinical and cosmetic effect. The case is interesting due to the application of minimally invasive technique in an infant of the first months of life.
Pericardectomy is an effective treatment method of purulent and fibrinopurulent pericarditis. Thoracoscopic pericardectomy is an effective and feasible alternative to thoracotomy and sternotomy; since it is a minimally invasive procedure advantageous in reducing tissue response to trauma and for rapid recovery. Thoracoscopic pericardiectomy is an advisable surgical procedure for pyopericardium in children and requires further study of the long-term results.

Keywords: pericarditis, thoracoscopy, pericardectomy, children, pericardium, pericardiocentesis, trauma
p. 194-201 of the original issue
References
  1. Bairov GA, Roshal' LM. Gnoinaia khirurgiia detei [Contaminated surgery in children]. Leningrad, RF: Meditsina; 1991. 270p.
  2. Cakir O, Gurkan F, Balci AE, Eren N, Dikici B. Purulent pericarditis in childhood: ten years of experience. J Pediatr Surg. 2002 Oct;37(10):1404-8.
  3. Augustin P, Desmard M, Mordant P, Lasocki S, Maury JM, Heming N, et al. Clinical review: intrapericardial fibrinolysis in management of purulent pericarditis. Crit Care. 2011 Apr 20;15(2):220. doi: 10.1186/cc10022.
  4. Pankuweit S, Ristić AD, Seferović PM, Maisch B. Bacterial pericarditis: diagnosis and management. Am J Cardiovasc Drugs. 2005;5(2):103-12.
  5. Ohtsuka T, Takamoto S, Nakajima J, Miyairi T, Kotsuka Y. Minimally invasive limited pericardiectomy: the hybrid approach. Ann Thorac Surg. 2000 Oct;70(4):1429-30.
  6. Walsh PJ, Remedios AM, Ferguson JF, Walker DD, Cantwell S, Duke T. Thoracoscopic versus open partial pericardectomy in dogs: comparison of postoperative pain and morbidity. Vet Surg. 1999 Nov-Dec;28(6):472-79.
  7. Dupré GP, Corlouer JP, Bouvy B. Thoracoscopic pericardectomy performed without pulmonary exclusion in 9 dogs. Vet Surg. 2001 Jan-Feb;30(1):21-7.
  8. Liem NT, Tuan T, Dung le A. Thoracoscopic pericardiectomy for purulent pericarditis: experience with 21 cases. J Laparoendosc Adv Surg Tech A. 2006 Oct;16(5):518-21.
  9. Agrawal V, Saxena A, Sethi A, Acharya H, Sharma D. Thoracoscopic pericardiotomy for management of purulent pneumococcal pericarditis in a child. Asian J Endosc Surg. 2012 Aug;5(3):145-48. doi: 10.1111/j.1758-5910.2011.00129.x.
  10. Zitsman JL. Current concepts in minimal access surgery for children. Pediatrics. 2003 Jun;111(6 Pt 1):1239-52.
  11. Razumovskii AIu, Mitupov ZB. Endokhirurgicheskie operatsii v torakal'noi khirurgii u detei [Endosurgical operations in thoracic surgery of children]: ruk. Moscow, RF: GEOTAR-Media; 2010. 304 p.
  12. Huddleston CB. Mediastinal wound infections following pediatric cardiac surgery. Semin Thorac Cardiovasc Surg. 2004 Spring;16(1):108-12.
Address for correspondence:
220013, Republic of Belarus,
Minsk, Nezavisimosti ave.,
64, SE "Republican Research and Practical Center for Pediatric Surgery"
Tel.: 375 29 306-64-37
E-mail: dr.tsimashok@gmail.com
Valeriy L. Timoshok
Information about the authors:
Timoshok V.L. Cardiosurgeon of department of cardiosurgery N2, SE "Republican Research and Practical Center for Pediatric Surgery", Minsk.
Svirsky A.A. PhD, Ass. Professor, Head of department of pediatric surgery SE "Republican Research and Practical Center for Pediatric Surgery", Minsk.
Korolkova E.V. Head of department of pediatric cardiosurgery, SE "Republican Research and Practical Center for Pediatric Surgery",
Minsk.
Drozdovsky K.V. PhD, Director of SE "Republican Research and Practical Center for Pediatric Surgery", Minsk.
Makhlin A.M. Deputy Director (clinical work), SE "Republican Research and Practical Center for Pediatric Surgery", Minsk.
Dedovich V.V. Head of department of cardiosurgery N2, SE "Republican Research and Practical Center for Pediatric Surgery",
Minsk.
Shalkevich A.L. Head of department of anesthesia and intensive care N3, SE "Republican Research and Practical Center for Pediatric Surgery", Minsk.
Drozdovskaya V.V. Cardiologist (the first category) of department of cardiosurgery N2, SE "Republican Research and Practical Center for Pediatric Surgery", Minsk.
Contacts | ©Vitebsk State Medical University, 2007