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Thoracoplasty: current application to the infected pleural space.
1Division of Cardiothoracic Surgery, Case-Western Reserve University School of Medicine, Cleveland, Ohio.
The Annals of Thoracic Surgery
|November 1, 1990
Summary
Thoracoplasty effectively obliterates infected pleural spaces, even in complex cases with prior surgeries or tuberculosis. This surgical technique remains a valuable option for managing persistent empyema and bronchopleural fistulas.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Infectious Diseases
Background:
- Thoracoplasty was historically used for cavitary pulmonary disease.
- Its current role includes managing infected pleural spaces.
Purpose of the Study:
- To evaluate the efficacy of thoracoplasty in patients with infected pleural spaces.
- To assess outcomes in patients with chronic empyema and bronchopleural fistulas.
Main Methods:
- Retrospective review of 13 patients undergoing thoracoplasty between 1976 and 1989.
- Inclusion of patients with chronic empyema, post-resection complications, and post-pneumonectomy empyema.
- Surgical technique involved pleural and intercostal muscle resection, with muscle flaps for bronchopleural fistula closure.
Main Results:
- All 13 patients survived the procedure.
- Successful obliteration of infected pleural spaces was achieved in all cases.
- Patients experienced acceptable physiological and cosmetic outcomes.
Conclusions:
- Thoracoplasty is a useful and effective procedure for managing select patients with infected pleural spaces.
- The technique is particularly valuable in cases with rigid cavity walls and bronchopleural fistulas.
- Thoracoplasty offers successful outcomes even in patients with complex histories of pulmonary resection.