From August 1990 through December 1991, 14 patients (all males) underwent intrathoracic muscle transposition of extrathoracic skeletal muscles to treat empyemas. 6 patients had tuberculous empyemas, 4 had chronic empyemas of unknown etiology, 3
had
postpneumonectomy empyemas, and 1 had postlobetomy empyema. 9 patients had associated bronchopleural fistular. Their ages ranged from 22 to 67 years. With mean age of 45.1±17.6(±S.D) years.
The serratus anterior was transposed in 13 patients, the latissimus dorsi in 12. In 11 patients, both the serratus anterior and the latissimus dorsi were transposed. The omental flapalso transposed in 3 patients. To reduce the dead space in the
thoracic
cavity, thoracoplasty was also carried out in 10 patients. The number of the partially resected ribs was 3.0±0.8(±S.D). All operations were single stage procedures, and all wounds were closed primarily, with no permanent tubes or chest wall
openings.
There was no hospital mortality, and so no subsequent operation has been required. Follow-up of the patients ranged from 5 to 16 months with a mean of 9.2±3.1(±S.D) months. All the patients had no further signs or symptoms of the original
infection
after discharge.
We conclude that intrathoracic transposition of extrathoracic skeletal muscle is an excellent method of treatment for persistent, life-threatening intrathoracic infections.
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