持続腹膜透析により発見され,胸腔鏡下に治療した横隔膜交通症の一例

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  • Video-assisted thoracoscopic treatment for a patient with pleuroperitoneal communication complicating CAPD.

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A 53-year-old female presented in end-stage renal failure. She had been receiving continuous ambulatory peritoneal dialysis from August 1999. She developed acute hydrothorax in the right pleural cavity on January 2000. She was admitted to our hospital for the surgical treatment of pleuroperitoneal communication. We performed video-assisted thoracoscopic surgery. Using a dialysis solution with indigo carmine dye through CAPD catheter, we found three blebs on the diaphragm that expanded gradually. We diagnosed these lesions as pleuroperitoneal communication. The defects of the diaphragm were directly ligated with the instrument for endoscopic knot tying. Post-operative course was very favorable. She could restart CAPD on POD (postoperative days) 7 and was discharged from our hospital on POD 16. No recurrence of hydrothorax has been detected in the year after surgical treatment.

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