What is a Resection of Pericardial Cyst or Tumour?
Resection of Pericardial Cyst or Tumour is a surgical procedure to excise a tumour and pericardial cysts from the sac that surrounds the heart. The pericardial sac (or pericardium) is a thin, double-walled membrane that protects the heart and parts of the aorta. It has small openings to allow the movement of blood and air into the heart.
A pericardial cyst is a growth in the pericardium that can set up an independent circulatory system. Over time, the cyst can become large and cause a variety of symptoms, including chest pain, shortness of breath, and difficulty swallowing. The cyst can also lead to a fluid buildup in the pericardium which can further impact the heart’s ability to pump.
Pericardial tumours are rare. They can be benign or malignant. In some cases, benign tumours can still lead to serious health problems. The primary treatment for a pericardial cyst or tumour is surgical resection.
Overview of Resection of Pericardial Cyst or Tumour
Resection of Pericardial Cyst or Tumour is an extremely complex surgical procedure that requires a highly skilled team of surgeons and other doctors. It involves the removal of the entire tumour or cyst along with some of the surrounding tissue from the pericardium. This procedure is typically done through a median sternotomy, which is an incision in the chest down the centre of the sternum.
The surgeons will typically remove the cyst or tumour while avoiding other organs in the chest cavity as much as possible. In some cases, the entire pericardium may need to be resected and replaced with a synthetic replacement. This procedure can be risky and is often avoided except in cases where the tumour is malignant or when the pericardial effusion (fluid buildup) is causing significant compression of the heart.
Benefits of Resection of Pericardial Cyst or Tumour
Resection of Pericardial Cyst or Tumour offers many important advantages for patients. By removing the cyst or tumour, the heart can return to its normal functioning state, and any pressure that was being caused by the fluid buildup will dissipate. This generally allows for improved heart function and a faster recovery time.
In addition, removal of the cyst or tumour greatly reduces the risk of it becoming cancerous or further growing and causing complications. Finally, the procedure eliminates the need for regular testing and other treatments that can be excessively costly and time-consuming.
Expected Results of Resection of Pericardial Cyst or Tumour
The primary goal of Resection of Pericardial Cyst or Tumour is to eliminate the cyst or tumour and to restore the heart to its normal functioning state. When the procedure is successful, patients can generally expect to experience improved heart function, a decrease in any symptoms that were previously caused by the cyst or tumour, and an increase in overall quality of life.
In most cases, the patient should be able to return to their normal activities within a few weeks or months. However, recovery times will vary depending on the type of procedure, the patient’s overall health, and the extent of the cyst or tumour.
It is important to keep in mind that the success of this procedure can never be guaranteed. There are potential risks and complications that can occur, including the possibility that the tumour could come back. Patients should talk to their doctor about the best possible treatment plan for their individual circumstances.
Conclusion
Resection of Pericardial Cyst or Tumour is a complex but often successful surgical procedure that can provide patients with the opportunity to improve their heart function and to reduce the symptoms associated with a cyst or tumour in the pericardium. The procedure can be risky, so it is important to discuss all potential risks and complications with your doctor prior to undergoing the procedure. With proper care and management, the results of Resection of Pericardial Cyst or Tumour can be positive and long-lasting.
Definition & Overview
Pericardial cysts are rare congenital abnormalities that usually develop in the middle mediastinum or the central compartment in the chest cavity. It contains most of the organs of the thoracic cavity including the pericardium. The pericardium is a double-layered sac that envelops the heart. It protects the heart from shock and infection and lubricates it with pericardial fluid.
Pericardial cysts are usually benign and affect just 1 in 100,000 people. Most patients with this condition do not present any symptoms. Those who do, experience laboured breathing and persistent cough, among others. In the majority of cases, the cysts are accidentally discovered when patients undergo echocardiography or x-ray for unrelated medical conditions.
In some cases, pericardial cysts resolve without treatment specially when they rupture into the pleural space. However, if they rupture around the pericardial cavity, they can cause serious cardiac tamponade that requires surgery. To prevent serious complications, surgeons can recommend their removal through a surgical procedure.
Who Should Undergo and Expected Results?
The procedure is recommended for patients who were diagnosed with having a pericardial cyst or tumour. As mentioned above, most patients with this condition are asymptomatic. Some, on the other hand, exhibit various symptoms including breathlessness, chronic cough, chest pain, and low blood pressure. Also, while pericardial cysts are mostly benign, they can pose some serious complications in some cases. Aside from cardiac tamponade, they can also obstruct the lungs. They can also cause congestive heart failure or spontaneous bleeding or haemorrhage in the area.
How is the Procedure Performed?
The main focus in managing pericardial cysts or tumours is to assess their growth and movement. Resecting them is often recommended if they are growing rapidly as this can lead to intracystic haemorrhage that can obstruct the blood vessels of the heart and lungs.
Before surgery is even recommended, pericardial cysts are observed using computed tomography (CT). The goals here are to determine if they are benign and to assess their link to nearby organs. Based on the assessment, percutaneous drainage (draining out of the cyst through the skin) or resection can be recommended.
The resection of pericardial cysts requires the use of general anaesthesia and thoracoscopy, a medical procedure where an internal mass within the pleural or thoracic cavity is resected and examined through biopsy.
For the procedure, a thoracoscope is inserted into the right midaxillary line (the middlemost line on the side of the body) and the 7th intercostal space. An intercostal space is the space between the ribs. Incisions are also made in the 4th and 5th intercostal spaces.
Surgeons use surgical scissors to fully grasp and cut out the cyst or tumours as well as the bridge that connects them to the pericardial cavity.
Pericardial cysts can also be managed through aspiration. This is a non-invasive procedure and thus results in fewer complications. The injection of a sclerosing agent can also be considered as this decreases the likelihood of recurrence. This is because the agent immediately dissolves the cysts and destroys the “roots“ that anchors them to nearby organs.
More and more surgeons now prefer thoracoscopy in carrying out the procedure and reserves thoracotomy (invasive surgical incision in the chest wall) as the last resort. During surgery, a fibreoptic cable is used to guide the surgeon and illuminate the target area. Specialised tools are used to resect cysts and tumours in the pericardium.
Possible Risks and Complications
The majority of patients who had their pericardial cysts or tumour resected did not experience serious postoperative complications. However, there are some cases where there was a need to redo the operation after new cysts or tumours were found. Doctors advocate that all masses must be initially identified and carefully evaluated prior to resecting them.
Pericardial cysts and tumours themselves cause complications because they can obstruct the major vessels of the heart including the superior vena cava and the ventricular wall. They can also cause cardiac tamponade, atrial fibrillation, or irregular heartbeat that can lead to blood clots, stroke, or in extreme cases, complete heart failure.
In studies made around the globe, there were no complications observed during and after surgery. Even the one-year follow-up period showed no serious complications among patients who underwent the procedure.
However, surgeons still require patients to keep up with their follow-up schedule to check for signs of recurrence and possible complications.
References:
The Cardiothoracic Surgery Network; “Pericardial Cyst” http://www.ctsnet.org/article/pericardial-cyst
Oxford Journals; “Surgical resection of a giant pericardial cyst showing a rapidly growing feature” http://icvts.oxfordjournals.org/content/10/6/1056.full
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Very interesting article. Thanks for sharing! #medicaldictionary #ressection #pericardialcyst
Great article! Really helpful to understand the procedure. #ressection #medicalprocedure