No abstract available.
Thoracoplasty*

No abstract available.
Paraffin* ; Thoracoplasty* ; Tuberculosis, Pulmonary*

Primary malignant fibrous histocytoma (MFH) of pleura is very rare. Upon microscopic examination, the tumor was characterized by storiform pattern of growth and intense, diffuse immunostaining for alpha l-antichymotripsin. We report a case of primary malignant pleural fibers histiocytoma with extension to lung, which was managed by complete excision of pleural mass and lobectomy with thoracoplasty.
Histiocytoma ; Histiocytoma, Malignant Fibrous* ; Lung ; Pleura* ; Thoracoplasty

Tailoring thoracoplasty is employed prior to, following, or concomitant with pulmonary resection when it is anticipated that insufHclent lung tissue will remain to fill the pleural space following a pulmonary resection. This study reviewed a series of eight patients treated with tailoring thoracoplasty between 1990 and 1995. Indications were to close a persistent space In four patients and to tailor the thoracic cavity to accept diminished lung volume concomitant with a pulmonary resection in the other four patients. The primary underlying disease was lung cancer in three patients and pulmonary tuberculosis In five patients, two of whom had concomitant aspcrgilloma, two, pneumothora, and one, empyema with bronchopleural fistula. In four patients with a prior pulmonary resection, the tailoring thoracoplasty was performed within eight days after the resection surgery. There was no failure to accommodate the thoracic cavity to insufficient lung tissue, even though two patients needed a second thoracoplasty. We conclude that tailoring thoracoplasty may be performed to close anticipated persistent pleural space and to accommodate diminished lung volume with acceptable cosmetic results Early, after, or concomitant with pulmonary resection in selected patients.
Empyema ; Fistula ; Humans ; Lung ; Lung Neoplasms ; Thoracic Cavity ; Thoracoplasty* ; Tuberculosis, Pulmonary

A 43-yr-old patient visited our department with intermittent chest pain he had suffered with for the past 2 months. Chest CT showed an egg shaped mass in the left chest wall. Local resection was performed for distinguishing the mass from a neurogenic tumor. The diagnosis was periosteal Ewing sarcoma of the rib. Since there was no evidence of metastasis based on the PET-CT, a 2nd operation was done with wide resection and thoracoplasty. The patient was then treated with combined chemotherapy. There has been no local recurrence for the last 1 year. The patient's age and tumor origin were distinct from the usual characteristics of Ewing's sarcoma. Periosteal Ewing's sarcoma of the rib has rarely been reported. We report here on a case of periosteal Ewing's sarcoma of the rib along with a review of the relevant medical literature.
Chest Pain ; Humans ; Neoplasm Metastasis ; Ovum ; Recurrence ; Ribs ; Sarcoma, Ewing ; Thoracic Wall ; Thoracoplasty ; Thorax

We report the rare case of a 58-year-old woman who was diagnosed with fungal empyema thoracis combined with osteoradionecrosis. After 32 months of home care followed by open window thoracostomy, thoracoplasty with serratus anterior muscle transposition and a latissimus dorsi myocutaneous flap was performed successfully. Although thoracoplasty is now rarely indicated, it is still the treatment of choice for the complete obliteration of thoracic spaces.
Empyema* ; Female ; Home Care Services ; Humans ; Middle Aged ; Myocutaneous Flap* ; Osteoradionecrosis* ; Superficial Back Muscles ; Thoracoplasty* ; Thoracostomy

BACKGROUND: Pulmonary aspergilloma is a potential life-threatening disease resulting from massive hemoptysis. Pulmonary aspergilloma has been treated surgically for many years, however, it has also had higher risk of mortality and complication rate. The purpose of this study is to analyze the operative methods and the types of complications. MATERIAL AND METHOD: Sixty patients who underwent surgical resection for pulmonary their medical reconrds. RESULT: The mean age was 46.3+/-13.4 years(range 20 to 76 years). The most common clinical presentation was hemoptysis which occurred in 48 patients(80%). Pulmonary tuberculosis was the most common pre-existing disease, occurri9ng in 28 patients(46.7%). The other associated lung diseases were bronchiectasis(n=11), silicosis(n=2), and chronic pnumonia(n=1). Operative proceudres wer lobectomy in 35 patients, pneumonectomy in 6, segmentectomy in 5, lobectomy and thoracoplasty in 3, segmentectomy and thoracopasty in 1, and cavernostomy in 10. The operative mortality was 6%(n=3) in lung resection patients but 0% in cavernostomy patients. The most common complications were prolonged air leakage, wound infection and postoperative bleeding. CONCLUSIONS: In most cases of pulmonary aspergilloma surgical resectin remains the only effective therapy. However, cavernostomy may be more effective for pulmonary aspergilloma patients with decreased pulmonary functions and for patients with high risk for lung resection.
Hemoptysis ; Hemorrhage ; Humans ; Lung ; Lung Diseases ; Mastectomy, Segmental ; Mortality ; Pneumonectomy ; Preexisting Condition Coverage ; Pulmonary Aspergillosis ; Thoracoplasty ; Tuberculosis, Pulmonary ; Wound Infection

PURPOSE: To evaluate the patterns of preoperative pulmonary function tests(PFTs) and their correlation with postoperative pulmonary impairment in patients with adolescent idiopathic scoliosis(AIS), who had orthopaedic operation with or without rib resection thoracoplasty. METHODS: The case records and radiographs of 79 patients(12, boys and 67, girls) of a mean age of 13.3 years(7-15 years) with AIS who underwent orthopaedic operations at the author's institute between 1997 and 2003 were reviewed. RESULTS: The average preoperative coronal Cobb measurement was 56 (range, 32-81 ). Thirty-one patients(39%) had normal values of of PFTs. Forty five patients(57%) with severe scoliosis(Cobb's angle 65-90 ) showed mild to moderate decrease on PFTs with FVC(73%), FEV1(79%), FEV25-75%(58 %). The severity of Cobb's angle were correlated with the decrease in FVC, FEV1, FEV25-75%(P< 0.05). Forty-three patients had thoracoplasty. Twenty-two(51%) of them had pleural effusions. Eleven patients among them had chest tube inserted postoperatively. But, none of the patients had any increased requirement of postoperative ventilatory support. The incidence of postoperative pulmonary effusion in patients with thoracoplasty was a 17-fold increase, compared to the patients without thoracoplasty(O.R.=17, chi-squared-test, P<0.05). CONCLUSION: The fall in FVC and FEV1 of patients with mild to moderate scoliosis(Cobb's angle, below 65 ) was mild and was unlikely to be of clinical significance. It appeared that patients with severe AIS had mild to moderate restrictive patterns with reduced lung volumes. Performance of the thoracoplasty was the important risk factor for postoperative pulmonary complications in patients underwent surgical operation.
Adolescent* ; Chest Tubes ; Humans ; Incidence ; Lung ; Pleural Effusion ; Reference Values ; Respiratory Function Tests ; Ribs ; Risk Factors ; Scoliosis* ; Thoracoplasty

BACKGROUND: Post-pneumonectomy empyema(PPE) is an uncommon but a serious complication. The management remains as challenge for general thoracic surgeons. MATERIAL AND METHOD: During the period of January 1990 to December 1996, we evaluated the results of 20 patients with post-pneumonectomy empyema. RESULT: Sex ratio were 15 male and 5 female patients with mean age of 41.5+/-21.5 yrs. The occurrence ratio of left to right side was 8:12. The most common disease for prior pneumonectomy was pulmonary tuberculosis. The duration between pneumonectomy and PPE was variable in 1 month to 6yrs. Fever was the most frequent symptom and S. aureus was the most frequent pathogen. In 13 cases, there were combined with BPF. Four patients underwent trans-sternal closure, and Clagett procedure was performed. There was one recurrence that later underwent muscle plombage and omentopexy later. Nine patients underwent omentopexy, muscle plombage and thoracoplasty. There were 7 cases that were not combined with BPF. All 7 patients underwent thoracoplasty, and two of them were combined with muscle plombage. Mean follow-up duration is 40+/-32.3 months. There were no late deaths nor recurrences of PPE. CONCLUSION: We conclude that early diagnosis and proper drainage in PPE patients are important in its initial stage of management, and also management is completely achieved in thoracoplasty with muscle plombage or omentopexy.
Drainage ; Early Diagnosis ; Empyema* ; Female ; Fever ; Follow-Up Studies ; Humans ; Male ; Pneumonectomy ; Recurrence ; Sex Ratio ; Thoracoplasty ; Tuberculosis, Pulmonary

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.
Empyema* ; Female ; Fistula ; Follow-Up Studies ; Hepatitis ; Humans ; Lung ; Male ; Mortality ; Pneumonectomy ; Recurrence ; Sepsis ; Surgical Flaps* ; Thoracoplasty*