Successful treatment of thoracoscopic pleurodesis using PGA felt: A case report

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The patient was an 81-year-old woman. Right pleural effusion was noted in March 2010 when she received treatment for hepatitis C infection and hepatic cirrhosis, for which paracentesis and aspiration were regularly performed on an outpatient basis. Fluid accumulation became frequent and was associated with respiratory discomfort; thus, she was referred to our department. In spite of thoracic cavity drainage and pleurodesis performed after admittance, effusion control was difficult and thoracoscopic surgery was performed. The entire diaphragm was covered with bioabsorbable prostheses made from polyglycolic acid (PGA felt), as no diaphragmatic defects were noted via thoracoscopy. Pleural effusion accumulation disappeared 2 weeks after surgery and has not recurred. In the present case, we speculated that the diaphragmatic defects were likely closed, as the entire diaphragm and bottom surface of the lung were fully adhered, while no defects were found on the diaphragm. There have been a variety of reports of treatment for intractable hepatic hydrothorax. We consider that the present approach is a simplified method of thoracoscopic pleurodesis.