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Updated: Jun 24, 2026
03:22
Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
Prosthesis for open pleurostomy (POP): management for chronic empyemas
Luiz Tarcísio Brito Filomeno1, José Ribas Milanez de Campos, Tiago Noguchi Machuca
1Department of Thoracic Surgery, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo/SP, Brazil.
Clinics (Sao Paulo, Brazil)
|March 31, 2009
Summary
A novel prosthesis for open pleurostomy offers an effective alternative to conventional methods for managing chronic empyema. This minimally invasive approach achieved high infection control rates, improving patient outcomes.
Area of Science:
- Thoracic Surgery
- Medical Devices
- Infectious Diseases
Background:
- Open pleural window procedures for chronic empyema can cause significant chest wall deformity and patient distress.
- Conventional methods may not be suitable when pulmonary decortication is not indicated or in cases of post-pneumonectomy space infection.
Purpose of the Study:
- To evaluate the efficacy of a newly developed prosthesis for open pleurostomy in managing chronic empyema.
- To compare the outcomes of this prosthesis with the conventional open pleural window procedure.
Main Methods:
- A self-retained silicone tube prosthesis for open pleurostomy was inserted in 44 consecutive patients with chronic empyema.
- Etiologies included parapneumonic (20), post-lung resection (12), tuberculous (6), and malignant (6) effusions.
- The prosthesis was attached to a drainage bag after pleural debridement.
Main Results:
- Excellent infection control was achieved in 100% of parapneumonic and tuberculous empyemas.
- Successful infection control rates were 75-85% for post-lung resection and malignant cases.
- Lung re-expansion rates varied by etiology, ranging from 33% to 93%.
Conclusions:
- Prosthesis for open pleurostomy insertion is a minimally invasive and effective treatment for chronic empyemas.
- This device offers comparable efficacy to the conventional open pleural window.
- The study proposes the prosthesis as a replacement for the conventional open pleural window technique.
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