|
KMID : 0364020070400060420
|
|
Korean Journal of Thoracic and Cardiovascular Surgery
2007 Volume.40 No. 6 p.420 ~ p.427
|
|
|
Surgical Results for Treating Postpneumonectomy Empyema with BPF by Using an Omental Pedicled Flap and Thoracoplasty
|
|
Jeong Seong-Cheol
Kim Mi-Jung
Song Chang-Min
Kim Woo-Sik
Shin Yong-Chul
Kim Byung-Yul
|
|
|
Abstract
|
|
|
Background: Postpneumonectomy empyema (PPE) due to bronchopleural fistula (BPF) can be a surgical challenge for surgeons. We analyzed the follow-up outcomes after performing omentopexy and thoracoplasty for the treatment of PPE with BPF after pneumonectomy.
Material and Method: Between December 1991 and January 2006, 9 patients underwent BPF closure using an omental pedicled flap for the treatment of PPE with BPF after pneumonectomy. There were 7 males and 2 females (mean age: 45.9±9 years). The patients were followed up for a mean of 58 months (median: 28 months, range: 6∼169). When we performed omentopexy, the surgical procedures for empyema were thoracoplasy for 8 patients and the Clagett procedure for 1 patient. Thoracoplasty was performed for the latter patient due to recurrence of empyema.
Result: For the 8 patients who were treated by omentopexy and thoracoplasty, there was 1 operation-related death due to sepsis. During follow up, 1 patient, who was treated by omentopexy and a Clagett procedure, died of acute hepatitis 40 months postoperatively. The early mortality was 11.1% (8/9). Of the 8 patients, including the 1 late death patient, successful closure of the BPF were achieved in all patients (8/9) and the empyema was cured in 7 patients (7/8).
Conclusion: The BPF closure using an omental pedicled flap was an effective method for treating PPE with BPF due to TB-destroyed lung, and thoracoplasty with simultaneous omentopexy was effective and safe for removing dead space if the patient was young and in a good general condition.
|
|
|
KEYWORD
|
|
|
Empyema, Bronchopleural fistula, Omental flap, Thoracoplasty
|
|
|
FullTexts / Linksout information
|
|
 
|
|
|
Listed journal information
|
|
  
|