Korean J Nephrol.  2002 Sep;21(5):855-860.

Peritoneopleural Leakage in Continuous Ambulatory Peritoneal Dialysis : Successful Treatment with Video-Assisted Thoracoscopic Talc Pleurodesis

• Kim UA
• Kim DJ
• Yeo HM
• Lim YH
• Kim B
• Kang WH
• Yoon SJ
• Lee HH
• Lee YK
• Oh HY

Abstract

Continuous ambulatory peritoneal dialysis (CAPD) is an effective renal replacement therapy for end- stage renal disease. Hydrothorax secondary to leakage of dialysate via pleuroperitoneal communication is a rare complication of CAPD. Earlier treatments of CAPD-induced hydrothorax have included pleurodesis with tetracycline, talc, fibrin, or autologous blood and surgical treatment. These procedure have made many patients switch to hemodialysis, because of the high relapse rate of the former and the invasiveness and morbidity of the latter. The talc pleurodesis with video-assisted thoracic surgery (VATS) allows not only direct visualization of potential diaphragmatic defect but also direct application of the talc to the visceral or parietal pleura. This procedure is less invasive than thoracotomy and can perform more accurate poudrage of talc than conventional methods. We have recently managed a patient CAPD-induced massive hydrothorax using thoracoscopic talc pleurodesis. This patient was successfully returned to CAPD.

Keyword

Hydrothorax; CAPD; Thoracoscopy; Pleurodesis; Leakage

MeSH Terms

Fibrin
Humans
Hydrothorax
Peritoneal Dialysis, Continuous Ambulatory*
Pleura
Pleurodesis*
Recurrence
Renal Dialysis
Renal Replacement Therapy
Talc*
Tetracycline
Thoracic Surgery, Video-Assisted
Thoracoscopy
Thoracotomy
Fibrin
Talc
Tetracycline