{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T21:20:39Z","timestamp":1779916839011,"version":"3.53.1"},"reference-count":20,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Malignant pericardial effusion (MPE) represents a relatively rare complication in various types of solid tumors. Its management is often challenging. One solution can be represented by surgical approaches, including a pericardio-peritoneal window (PPW), which allows draining the fluid into the abdominal cavity. The aim of this study is to investigate the efficacy and long-term outcomes of the PPW procedure as a definitive therapeutic strategy for MPE. Materials and methods: We retrospectively and prospectively observed pre-, peri-, and postoperative data of patients undergoing pericardio-peritoneal window creation from 2010 to December 2023 at the European Institute of Oncology (IEO), including the surgical procedures needed, total and specific postoperative complications, 30-day mortality rate, relapse rate, and the treatment of possible relapses. Results: A total of 44 consecutive patients underwent a pericardio-peritoneal window. In 28 patients (63.8%) PPW was associated with mono or bilateral videothoracoscopy for pleural biopsies\/talc poudrage. In 23 cases, pre-operative percutaneous pericardial drainage (usually 1\u20132 days before surgery) was performed. No intraoperative deaths were observed. The 30-day mortality was 9% (four patients). We observed pericardial effusion recurrence in three patients at two months and in five patients at six months. In only two cases we treated this condition because of a pre-tamponade condition, treated by percutaneous pericardial drainage. The success rate of the PPW regarding pericardial relapse requiring further procedures was 95.5%. Conclusions: Patients presenting with a favorable short-term prognosis benefit from the pericardio-peritoneal window as a safe and effective method for resolving malignant pericardial effusion. Conversely, pericardial drainage is recommended as the most appropriate therapy for those with a less favorable prognosis.<\/jats:p>","DOI":"10.3390\/jcm15010083","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T16:41:19Z","timestamp":1766594479000},"page":"83","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Recurrent Malignant Pericardial Effusion Management: The Pericardio-Peritoneal Window"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5330-5495","authenticated-orcid":false,"given":"Antonio","family":"Mazzella","sequence":"first","affiliation":[{"name":"Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Caffarena","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7320-9951","authenticated-orcid":false,"given":"Claudia","family":"Bardoni","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1002-0901","authenticated-orcid":false,"given":"Giuseppe","family":"Nicolosi","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5309-4704","authenticated-orcid":false,"given":"Patrick","family":"Maisonneuve","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Cerretani","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7482-1544","authenticated-orcid":false,"given":"Giulia","family":"Sedda","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1153-3334","authenticated-orcid":false,"given":"Luca","family":"Bertolaccini","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"},{"name":"Department of Oncology and Haemato-Oncology, University of Milan, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2629-7781","authenticated-orcid":false,"given":"Giorgio","family":"Lo Iacono","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5986-7811","authenticated-orcid":false,"given":"Monica","family":"Casiraghi","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"},{"name":"Department of Oncology and Haemato-Oncology, University of Milan, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Spaggiari","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"},{"name":"Department of Oncology and Haemato-Oncology, University of Milan, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1111\/j.1755-5922.2010.00151.x","article-title":"Treatment of pericardial disease","volume":"29","author":"Azam","year":"2011","journal-title":"Cardiovasc. 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