Surgical Results for Treating Postpneumonectomy Empyema with BPF by Using an Omental Pedicled Flap and Thoracoplasty.
- Author:
Seong Cheol JEONG
1
;
Mi Jung KIM
;
Chang Min SONG
;
Woo Shik KIM
;
Yong Chul SHIN
;
Byung Yul KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, National Medical Center, Korea. ice-bar@hanmail.net
- Publication Type:Original Article
- Keywords:
Empyema;
Bronchopleural fistula;
Omental flap;
Thoracoplasty
- MeSH:
Empyema*;
Female;
Fistula;
Follow-Up Studies;
Hepatitis;
Humans;
Lung;
Male;
Mortality;
Pneumonectomy;
Recurrence;
Sepsis;
Surgical Flaps*;
Thoracoplasty*
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2007;40(6):420-427
- CountryRepublic of Korea
- Language:Korean
-
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.
