TY - JOUR
T1 - The effectiveness and safety of computed tomographic peritoneography and video-assisted thoracic surgery for hydrothorax in peritoneal dialysis patients
T2 - A retrospective cohort study in Japan
AU - Matsuoka, Naoya
AU - Yamaguchi, Makoto
AU - Asai, Akimasa
AU - Kamiya, Keisuke
AU - Kinashi, Hiroshi
AU - Katsuno, Takayuki
AU - Kobayashi, Takaaki
AU - Tamai, Hirofumi
AU - Morinaga, Takatoshi
AU - Obayashi, Takaaki
AU - Nakabayashi, Kichio
AU - Koide, Shigehisa
AU - Nakanishi, Michimasa
AU - Koyama, Katsushi
AU - Suzuki, Yasuhiro
AU - Ishimoto, Takuji
AU - Mizuno, Masashi
AU - Ito, Yasuhiko
N1 - Publisher Copyright:
© 2020 Matsuoka et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/9
Y1 - 2020/9
N2 - Introduction Albeit uncommon, hydrothorax is an important complication of peritoneal dialysis (PD). Due to paucity of evidence for optimal treatment, this study aimed to evaluate the effectiveness and safety of computed tomographic (CT) peritoneography and surgical intervention involving video-assisted thoracic surgery (VATS) for hydrothorax in a retrospective cohort of patients who underwent PD in Japan. Methods Of the 982 patients who underwent PD from six centers in Japan between 2007 and 2019, 25 (2.5%) with diagnosed hydrothorax were enrolled in this study. PD withdrawal rates were compared between patients who underwent VATS for diaphragm repair (surgical group) and those who did not (non-surgical group) using the Kaplan-Meier method and log-rank test. Results The surgical and non-surgical groups comprised a total of 11 (44%) and 14 (56%) patients, respectively. Following hydrothorax diagnosis by thoracentesis and detection of penetrated sites on the diaphragm using CT peritoneography, VATS was performed at a median time of 31 days (interquartile range [IQR], 20–96 days). During follow-up (median, 26 months; IQR, 10–51 months), 9 (64.3%) and 2 (18.2%) patients in the non-surgical and surgical groups, respectively, withdrew from PD (P = 0.021). There were no surgery-related complications or hydrothorax relapse in the surgical group. Conclusions This study demonstrated the effectiveness and safety of CT peritoneography and VATS for hydrothorax. This approach may be useful in hydrothorax cases to avoid early drop out of PD and continue PD in the long term. Further studies are warranted to confirm these results.
AB - Introduction Albeit uncommon, hydrothorax is an important complication of peritoneal dialysis (PD). Due to paucity of evidence for optimal treatment, this study aimed to evaluate the effectiveness and safety of computed tomographic (CT) peritoneography and surgical intervention involving video-assisted thoracic surgery (VATS) for hydrothorax in a retrospective cohort of patients who underwent PD in Japan. Methods Of the 982 patients who underwent PD from six centers in Japan between 2007 and 2019, 25 (2.5%) with diagnosed hydrothorax were enrolled in this study. PD withdrawal rates were compared between patients who underwent VATS for diaphragm repair (surgical group) and those who did not (non-surgical group) using the Kaplan-Meier method and log-rank test. Results The surgical and non-surgical groups comprised a total of 11 (44%) and 14 (56%) patients, respectively. Following hydrothorax diagnosis by thoracentesis and detection of penetrated sites on the diaphragm using CT peritoneography, VATS was performed at a median time of 31 days (interquartile range [IQR], 20–96 days). During follow-up (median, 26 months; IQR, 10–51 months), 9 (64.3%) and 2 (18.2%) patients in the non-surgical and surgical groups, respectively, withdrew from PD (P = 0.021). There were no surgery-related complications or hydrothorax relapse in the surgical group. Conclusions This study demonstrated the effectiveness and safety of CT peritoneography and VATS for hydrothorax. This approach may be useful in hydrothorax cases to avoid early drop out of PD and continue PD in the long term. Further studies are warranted to confirm these results.
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U2 - 10.1371/journal.pone.0238602
DO - 10.1371/journal.pone.0238602
M3 - Article
C2 - 32881941
AN - SCOPUS:85090320585
SN - 1932-6203
VL - 15
JO - PloS one
JF - PloS one
IS - 9 September
M1 - e0238602
ER -