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Updated: Aug 14, 2026
03:22
Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
Flap closure of postpneumonectomy empyema
B M Michaels1, D P Orgill, M M Decamp
1Division of Plastic Surgery, Brigham and Women's Hospital, Boston, Mass., USA.
Plastic and Reconstructive Surgery
|February 1, 1997
Summary
Treating post-pneumonectomy empyema requires surgical intervention. Combining muscle flaps and thoracoplasty effectively manages these complex infections, with patient nutrition playing a key role in successful outcomes.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
Background:
- Empyema following pneumonectomy is a rare but serious complication.
- Recalcitrant cases present significant management challenges.
Purpose of the Study:
- To evaluate the efficacy of surgical strategies for post-pneumonectomy empyema.
- To identify factors influencing successful treatment outcomes.
Main Methods:
- Retrospective analysis of 16 patients treated between 1990-1994.
- Utilized pulse lavage, debridement, muscle flaps (pectoralis, serratus, latissimus, rectus, trapezius), and thoracoplasty.
- Patients categorized into one-stage (Group A) or two-stage (Group B) flap procedures.
Main Results:
- 11 patients underwent thoracoplasty; 4 required additional procedures.
- Significant variables for success included number of muscle flaps and ribs resected (p<0.007).
- Higher preoperative albumin levels correlated with better outcomes in the two-stage group (p=0.03).
Conclusions:
- Muscle flaps and thoracoplasty are effective for post-pneumonectomy empyema.
- Minimizing dead space and addressing bronchopleural fistulas are crucial.
- Adequate nutrition appears to be a significant factor in preventing recurrence.
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