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Postpneumonectomy empyema: results after the Clagett procedure
Salman Zaheer1, Mark S Allen, Stephen D Cassivi
1Division of General Thoracic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
The Annals of Thoracic Surgery
|June 27, 2006
Summary
The Clagett procedure effectively treats postpneumonectomy empyema, with 81% healing rates. Younger patients and longer intervals post-pneumonectomy predict better survival outcomes.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Infectious Diseases
Background:
- Postpneumonectomy empyema is a serious complication following lung removal surgery.
- The Clagett procedure is a surgical approach for managing this condition.
Purpose of the Study:
- To analyze the outcomes of the Clagett procedure in patients with postpneumonectomy empyema.
- To identify factors influencing survival and treatment success.
Main Methods:
- Prospective analysis of 84 patients with postpneumonectomy empyema treated between 1988 and 2004.
- The Clagett procedure involved open drainage, debridement, and antibiotic irrigation.
- Bronchopleural fistula closure and muscle flap reinforcement were assessed.
Main Results:
- Operative mortality was 7.1%.
- 81% of patients achieved chest wall healing without recurrent infection.
- Long-term survival was 44.5% at 5 years.
- Age under 65 and >15 weeks interval between pneumonectomy and empyema predicted better survival.
Conclusions:
- The Clagett procedure is a safe and successful treatment for most postpneumonectomy empyema cases.
- Patient age and the timing of empyema development are key factors for long-term outcomes.
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