Thoracoscopic surgical treatment for pleuroperitoneal communication

Interact Cardiovasc Thorac Surg. 2012 Oct;15(4):788-9. doi: 10.1093/icvts/ivs193. Epub 2012 Jun 29.


Hydrothorax as a result of pleuroperitoneal communication (PPC) is an uncommon but a well-known complication of continuous ambulatory peritoneal dialysis (CAPD). In this paper, we present a 60-year old man with diabetic renal failure who underwent CAPD. Two weeks after starting CAPD, chest radiographs showed a right-sided hydrothorax. Radioscintigraphy was performed and PPC was diagnosed. Eight days after the diagnosis, thoracoscopic surgery was performed. The leakage points were closed by direct suturing with absorbable polyglycolic acid felt and fibrin glue. The patient resumed CAPD 2 weeks later, and there was no recurrence of the right hydrothorax. Video-assisted thoracic surgery with direct suturing represents a feasible method for treating PPC with confirmed fistulae.

Publication types

  • Case Reports

MeSH terms

  • Diabetic Nephropathies / therapy*
  • Fibrin Tissue Adhesive / therapeutic use
  • Fistula / diagnosis
  • Fistula / etiology
  • Fistula / surgery*
  • Humans
  • Hydrothorax / diagnosis
  • Hydrothorax / etiology
  • Hydrothorax / surgery*
  • Male
  • Middle Aged
  • Peritoneal Dialysis, Continuous Ambulatory / adverse effects*
  • Peritoneal Diseases / diagnosis
  • Peritoneal Diseases / etiology
  • Peritoneal Diseases / surgery*
  • Polyglycolic Acid / therapeutic use
  • Radiopharmaceuticals
  • Renal Insufficiency / therapy*
  • Suture Techniques
  • Technetium Tc 99m Aggregated Albumin
  • Thoracic Diseases / diagnosis
  • Thoracic Diseases / etiology
  • Thoracic Diseases / surgery*
  • Thoracic Surgery, Video-Assisted*
  • Treatment Outcome


  • Fibrin Tissue Adhesive
  • Radiopharmaceuticals
  • Technetium Tc 99m Aggregated Albumin
  • Polyglycolic Acid