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Related Experiment Videos

Postpneumonectomy empyema.

Abbas El-Sayed Abbas1, Claude Deschamps

  • 1Resident, Division of General Thoracic Surgery, Mayo Clinic and Mayo Foundation, and Department of Surgery, Mayo Medical School, Rochester, Minnesota 55905, USA.

Current Opinion in Pulmonary Medicine
|June 11, 2002
PubMed
Summary
This summary is machine-generated.

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Empyema and bronchopleural fistula after pneumonectomy are serious complications. The Clagett and modified Clagett procedures offer effective treatment for over 80% of patients, focusing on pleural space infection and fistula closure.

Area of Science:

  • Thoracic Surgery
  • Pulmonary Medicine
  • Infectious Diseases

Background:

  • Empyema and bronchopleural fistula are significant complications following pneumonectomy.
  • Risk factors contribute to the increased incidence of these challenging conditions.

Purpose of the Study:

  • To describe preferred therapeutic methods for managing post-pneumonectomy empyema with bronchopleural fistula.
  • To outline surgical techniques aimed at resolving pleural space infection and bronchial stump issues.

Main Methods:

  • Repeated open debridements of the infected pleural space.
  • Primary closure of the bronchopleural fistula.
  • Covering the bronchial stump with intrathoracic transposition of extrathoracic skeletal muscle.
  • Delayed chest wall closure after antibiotic solution instillation (Clagett and modified Clagett procedures).

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Main Results:

  • Excellent treatment outcomes, achieving a healthy patient with a healed chest wall and no drainage or infection, in over 80% of cases.
  • Treatment success is linked to effective fistula management.

Conclusions:

  • The described Clagett and modified Clagett procedures are highly effective for post-pneumonectomy empyema with bronchopleural fistula.
  • Persistent or recurrent bronchopleural fistula is a primary cause of treatment failure.