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This study evaluates the efficacy and long-term outcomes of a pericardio-peritoneal window (PPW) as a definitive strategy, analyzing pre-, peri-, and postoperative data from patients treated between 2010 and December 2023 at the European Institute of Oncology.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/recurrent-malignant-pericardial-effusion-management-the-pericardio-peritoneal-window/461494/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/recurrent-malignant-pericardial-effusion-management-the-pericardio-peritoneal-window/461494.png","ImageObject",300,407,{"name":92,"@type":93},"pop out","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-09","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is the pericardio-peritoneal window (PPW) used for in malignant pericardial effusion?","Question",{"text":113,"@type":114},"PPW is a surgical approach that drains malignant pericardial effusion fluid into the abdominal cavity, evaluated here as a definitive therapeutic strategy for MPE.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the study conducted and what outcomes were tracked?",{"text":118,"@type":114},"The study observed patients retrospectively and prospectively, collecting pre-, peri-, and postoperative data including surgical procedures, postoperative complications, 30-day mortality, relapse rate, and management of relapses.",{"name":120,"@type":111,"acceptedAnswer":121},"What did the results show regarding mortality and pericardial recurrence?",{"text":122,"@type":114},"Thirty-day mortality was 9% (four patients), while pericardial effusion recurrence occurred in three patients at two months and five patients at six months.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},461494,1790824183,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146},962090760408,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Article  \nRecurrent Malignant Pericardial Effusion Management: The Pericardio-Peritoneal Window  \nAntonio Mazzella 1, *, Giovanni Caffarena 1, Claudia Bardoni 1, Giuseppe Nicolosi 1, Patrick Maisonneuve 2, Giorgia Cerretani 1, Giulia Sedda 1, Luca Bertolaccini 1,3, Giorgio Lo Iacono 1, Monica Casiraghi 1,3 and Lorenzo Spaggiari 1,3  \nAcademic Editors: Teruhiko Imamura and Hideki Ujiie  \nReceived: 16 November 2025  \nRevised: 15 December 2025  \nAccepted: 19 December 2025  \nPublished: 22 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; [giovanni.caffarena@ieo.it](giovanni.caffarena@ieo.it) (G.C.); [claudia.bardoni@ieo.it](claudia.bardoni@ieo.it) (C.B.); [giuseppe.nicolosi@unimi.it](giuseppe.nicolosi@unimi.it) (G.N.); [giorgia.cerretani@ieo.it](giorgia.cerretani@ieo.it) (G.C.); [giulia.sedda@ieo.it](giulia.sedda@ieo.it) (G.S.); [luca.bertolaccini@unimi.it](luca.bertolaccini@unimi.it) (L.B.); [giorgio.loiacono@ieo.it](giorgio.loiacono@ieo.it) (G.L.I.); [monica.casiraghi@ieo.it](monica.casiraghi@ieo.it) (M.C.); [lorenzo.spaggiari@ieo.it](lorenzo.spaggiari@ieo.it) (L.S.)  \n2 Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; [patrick.maisonneuve@ieo.it](patrick.maisonneuve@ieo.it)  \n3 Department of Oncology and Haemato-Oncology, University of Milan, 20141 Milan, Italy  \n* Correspondence: [antonio.mazzella@ieo.it](antonio.mazzella@ieo.it); Tel.: +39-02-57489-665; Fax: +39-02-94379-218  \nAbstract  \nIntroduction: 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 1–2 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.  \nKeywords: lung cancer; pericardial effusion; pericardio-peritoneal window; pericardial metastases; malignant pericardial effusion  \n1. Introduction  \nMalignant pericardial effusion (MPE) represents a severe and often late-stage complication in various types of cancer, with lung cancer, breast cancer, and lymphoma being the most fr","cbCaiiY8K1xw7Uvb","https://ap.wps.com/l/cbCaiiY8K1xw7Uvb","pdf",1110269,11,"English","# Abstract\n## Introduction\n## Materials and methods\n## Results\n## Conclusions\n# 1. Introduction","[{\"question\":\"What is the pericardio-peritoneal window (PPW) used for in malignant pericardial effusion?\",\"answer\":\"PPW is a surgical approach that drains malignant pericardial effusion fluid into the abdominal cavity, evaluated here as a definitive therapeutic strategy for MPE.\"},{\"question\":\"How was the study conducted and what outcomes were tracked?\",\"answer\":\"The study observed patients retrospectively and prospectively, collecting pre-, peri-, and postoperative data including surgical procedures, postoperative complications, 30-day mortality, relapse rate, and management of relapses.\"},{\"question\":\"What did the results show regarding mortality and pericardial recurrence?\",\"answer\":\"Thirty-day mortality was 9% (four patients), while pericardial effusion recurrence occurred in three patients at two months and five patients at six months.\"}]","Recurrent Malignant Pericardial Effusion Management - The Pericardio-Peritoneal Window | PDF",1790761728,28]