Treatment of the postoperative refractory empyema with a bronchopleural fistula by a pedicled or free muscle flap transplantation
10.3760/cma.j.cn114453-20200131-00022
- VernacularTitle:肌瓣或肌皮瓣移植治疗术后难治性脓胸合并支气管胸膜瘘
- Author:
Zhongliang HE
1
;
Lifeng SHEN
;
Weihua XU
;
Zhijun LIU
;
Guoxing CHEN
;
Xueming HE
;
Yongyong WU
;
Shunxin XIN
Author Information
1. 浙江省立同德医院心胸外科，杭州 310012
- Keywords:
Surgical flap;
Bronchopleural fistula;
Empyema;
Interventional treatment;
Surgical treatment
- From:
Chinese Journal of Plastic Surgery
2021;37(11):1239-1243
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and clinical efficacy of transplanting a muscle flap to treat the postoperative refractory empyema with a bronchopleural fistula.Methods:From July 2015 to December 2019, the clinical data of 15 patients who suffered from postoperative refractory empyema with bronchopleural fistula was retrospectively summarized. There were 13 males and two females with a mean age of 61.7 years. Ten cases had previous posterolateral thoracotomy and four cases underwent minimally invasive surgery. After conservative and endoscopic therapy, a pedicled latissimus dorsi muscle flap, a pectoralis major muscle flap, or a free vastus lateralis myocutaneous flap was harvested from the ipsilateral local thorax or thigh and was transferred to cover the intrathoracic cavity.Results:There was no perioperative death. During a mean follow-up of 14.8 months, one patient was dead, one suffered from a recurrence of refractory empyema, and l3 patients had an uneventful course with no recurrence of refractory empyema and bronchopleural fistula. Postoperative chest computed tomography or magnetic resonance imaging showed the empyema cavity was satisfactorily covered with a pedicle or free muscle flap.Conclusions:Muscle flap transplantation is an effective alternative for treating the postoperative refractory empyema with bronchopleural fistula, which can achieve promising short-medium-term results.
