Abstract
Developing pleuroperitoneal communication as a complication of continuous ambulatory peritoneal dialysis (CAPD) is rare; however, approximately 50% of patients who do require a conversion to hemodialysis. We report three cases of video-assisted thoracoscopic surgery (VATS) for pleuroperitoneal communication in patients undergoing CAPD, showing successful results. In case 1, the patient was a 47-year-old female. In case 2, the patient was a 73-year-old female. Both developed right hydrothorax on postoperative day (POD) 4 after the commencement of CAPD. In case 3, the patient was a 57-year-old male who developed right hydrothorax on POD 43 after the commencement of CAPD. We suspected that all three patients had pleuroperitoneal communication, and performed VATS in all of them. In case 1, we repaired the diaphragmatic defect with direct suture closure. In cases 2 and 3, we covered the diaphragm with a polyglycolic acid sheet and fibrin glue, because the diaphragmatic defects could not be detected. CAPD could be continued in cases 1 and 2. In case 3, the hydrothorax relapsed 10 months after the operation, and we therefore covered the diaphragm with a polyglycolic acid sheet and fibrin glue again. No recurrence has been detected since then, and CAPD has been continued. VATS is a minimally invasive surgery that contributes to the continuation of CAPD treatment, and, as a result, it is considered an effective surgical procedure for pleuroperitoneal communication.
