부산대학교 도서관

Objective: Peritoneal dialysis (PD)-related hydrothorax is a rare complication, which if not treated properly, will cause the patient to abandon PD. Methods: We started continuous ambulatory peritoneal dialysis (CAPD) treatment modality in 1991, and there have since been 400 consecutive patients receiving CAPD treatment (up to September 2007). Among them only 2 patients suffered from PD-related hydrothorax. In addition, the 2 patients who suffered from PD-related hydrothorax were referred from the other hospitals. Results: All the 4 patients were females, the mean age being 46 years old, and they presented with cough, dyspnea and inadequate outflow. Chest radiographs all showed massive effusion of the right thorax. The Tc99 shunt patency study was helpful in one case. All the 4 patients underwent VATS and one needed a limited thoracotomy due to failure of double lumen intubation. During the operation, all of them showed defects in the tendinous portion of the right side diaphragm which could be identified clearly after checking leakage. The defects were sutured continuously with 2-0 coated Vicryl. They resumed CAPD treatment 2~8 weeks after repair of the diaphragmatic defects. Conclusion: PD-related hydrothorax can be treated safely and successfully by VATS or limited thoracotomy.