Open Access

Tensioned space after pneumonectomy for cancer with mediastinal shift and cardiac tamponade‑causes and treatment (Review)

  • Authors:
    • Natalia Motas
    • Veronica Manolache
    • Ovidiu Rus
    • Mihnea Davidescu
    • Madalina Cristiana Cioalca‑iliescu
    • Bogdan Socea
    • Mihail Constantin Ceausu
    • Oana Gabriela Trifanescu
  • View Affiliations

  • Published online on: July 1, 2022     https://doi.org/10.3892/etm.2022.11485
  • Article Number: 548
  • Copyright: © Motas et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Regarding the pleural space after pneumonectomy for malignancy, a vast number of studies have assessed early drop in the fluid level, suggesting a broncho‑pleural fistula, but only a small number of studies reported on the abnormal increase in the fluid level‑a potentially lethal complication. In the present study, the available databases worldwide were screened and 19 cases were retrieved, including 14 chylothorax and 3 hydrothorax cases, 1 pneumothorax and 1 haemothorax case. Tension chylothorax is caused by mediastinal lymph node dissection as an assumed risk in radical cancer surgery. For tensioned haemothorax, the cause has not been elucidated, although lymphatic stasis associated with deep venous thrombosis was suspected. Tensioned pneumothorax was caused by chest wall damage after extrapleural pneumonectomy combined with low aspiration pressure on the chest drain. No cause was determined for none of the tensioned hydrothorax‑all 3 cases had the scenario of pericardial resection in addition to pneumonectomy in common. Tensioned space after pneumonectomy for cancer manifests as cardiac tamponade. Initial management is emergent decompression of the heart and mediastinum. Final management depends on the fluid type (chyle, transudate, air, blood) and the medical context of each case. Of the 19 cases, 12 required a major surgical procedure as the definitive management.

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September-2022
Volume 24 Issue 3

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Spandidos Publications style
Motas N, Manolache V, Rus O, Davidescu M, Cioalca‑iliescu MC, Socea B, Ceausu MC and Trifanescu OG: Tensioned space after pneumonectomy for cancer with mediastinal shift and cardiac tamponade‑causes and treatment (Review). Exp Ther Med 24: 548, 2022
APA
Motas, N., Manolache, V., Rus, O., Davidescu, M., Cioalca‑iliescu, M.C., Socea, B. ... Trifanescu, O.G. (2022). Tensioned space after pneumonectomy for cancer with mediastinal shift and cardiac tamponade‑causes and treatment (Review). Experimental and Therapeutic Medicine, 24, 548. https://doi.org/10.3892/etm.2022.11485
MLA
Motas, N., Manolache, V., Rus, O., Davidescu, M., Cioalca‑iliescu, M. C., Socea, B., Ceausu, M. C., Trifanescu, O. G."Tensioned space after pneumonectomy for cancer with mediastinal shift and cardiac tamponade‑causes and treatment (Review)". Experimental and Therapeutic Medicine 24.3 (2022): 548.
Chicago
Motas, N., Manolache, V., Rus, O., Davidescu, M., Cioalca‑iliescu, M. C., Socea, B., Ceausu, M. C., Trifanescu, O. G."Tensioned space after pneumonectomy for cancer with mediastinal shift and cardiac tamponade‑causes and treatment (Review)". Experimental and Therapeutic Medicine 24, no. 3 (2022): 548. https://doi.org/10.3892/etm.2022.11485