Medicina clinica · 2013
[Hepatic hydrothorax: report of a series of 77 patients].
Оценочное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Porcel José M, Mas Estela, Reñé Josep M, Bielsa Silvia
Аннотация
BACKGROUND AND OBJECTIVE: To describe the clinical characteristics, the most effective treatment and survival of cirrhotic patients with hepatic hydrothorax (HH).
PATIENTS AND METHOD: Descriptive and retrospective analysis of a cohort of consecutive patients with HH undergoing a diagnostic thoracentesis. The biochemical and radiological features of the pleural effusion, its control with different therapies and the factors affecting survival were evaluated, among other parameters.
RESULTS: Seventy-seven patients with HH were included, of whom 14% did not have ascites. HH was right-sided in 77% of the cases, and occupied half or more of the hemithorax in 68%. Pleural fluids were transudative in 81% of the cases. Diuretic-resistant HH (27%) could be managed with liver transplantation, transjugular intrahepatic portosystemic shunt (TIPS) or indwelling pleural catheters. However, pleurodesis failed in most patients. Median survival was 9.1 months, and it was only favorably affected by liver transplantation.
CONCLUSIONS: HH has a limited survival, only influenced by liver transplantation. In diuretic-resistant cases, TIPS or pleural indwelling catheters should be considered as a management option.
PATIENTS AND METHOD: Descriptive and retrospective analysis of a cohort of consecutive patients with HH undergoing a diagnostic thoracentesis. The biochemical and radiological features of the pleural effusion, its control with different therapies and the factors affecting survival were evaluated, among other parameters.
RESULTS: Seventy-seven patients with HH were included, of whom 14% did not have ascites. HH was right-sided in 77% of the cases, and occupied half or more of the hemithorax in 68%. Pleural fluids were transudative in 81% of the cases. Diuretic-resistant HH (27%) could be managed with liver transplantation, transjugular intrahepatic portosystemic shunt (TIPS) or indwelling pleural catheters. However, pleurodesis failed in most patients. Median survival was 9.1 months, and it was only favorably affected by liver transplantation.
CONCLUSIONS: HH has a limited survival, only influenced by liver transplantation. In diuretic-resistant cases, TIPS or pleural indwelling catheters should be considered as a management option.