Pericardiocentesis versus pericardiotomy for XXXX : a retrospective comparison.

@entity2294 @entity1 @entity5
BACKGROUND: Treatment of @entity2294 remains controversial, because no randomized controlled trials have been conducted to determine the best approach, and results of retrospective studies have been inconsistent. The objective of the present study was to compare pericardiocentesis and pericardiotomy with respect to efficacy for preventing recurrence, and to determine, for those two procedures, diagnostic yields, complication rates, and effects on survival. We also aimed to identify clinical and procedural factors that could predict effusion recurrence. METHODS: We retrospectively assessed 61 @entity1 who underwent a procedure for treatment of a @entity2294 at the Institut universitaire de cardiologie et de pneumologie de Qu  bec between February 2004 and September 2013. RESULTS: Pericardiocentesis was performed in 42 @entity1 , and pericardiotomy, in 19 @entity1 . The effusion recurrence rate was significantly higher in @entity1 treated with pericardiocentesis than with pericardiotomy (31.0% vs. 5.3%, p = 0.046). The diagnostic yield of the procedures was not significantly different (92.9% vs. 86.7%, p = 0.6). The overall rate of complications was similar in the two groups, as was the median overall survival (2.4 months vs. 2.6 months, p = 0.5). In univariate analyses, the procedure type was the only predictor of recurrence that approached statistical significance. Age, sex, type of @entity5 , presence of effusion at the time of @entity5 diagnosis, prior chest irradiation, tamponade upon presentation, and total volume of fluid removed did not influence the recurrence rate. CONCLUSIONS: Compared with pericardiocentesis, pericardiotomy had higher success rate in preventing recurrence of @entity2294 , with similar diagnostic yields, complication rates, and overall survival.
