Extended latissimus dorsi chimeric thoracoplasty with a vascular supercharge for Aspergillus empyema

Shimomura, Manabu; Sowa, Yoshihiro; Yamochi, Ryo; Inoue, Masayoshi

doi:10.1093/icvts/ivz280

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…In the past few years, standard thoracoplasty was often considered an abnormal surgery, and its indications were limited and not widely used. The reason is that most of the ribs, intercostal tissue and pleura need to be removed, which is a large surgical trauma and may even cause the chest wall to soften for a long time [ 30 , 31 ]. However, for patients with chronic empyema who have a huge abscess cavity and cannot use pedicled muscle flap or other myocutaneous flap, we can choose to use free myocutaneous flap.…”

Section: Discussionmentioning

confidence: 99%

Salvage treatment of acute respiratory failure after autogenous tissue flap transplantation for chronic empyema with chest wall sinus: a case report and literature review

Wang,

Chen,

et al. 2024

J Cardiothorac Surg

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Background Chronic empyema with chest wall sinus is a difficult and complex disease caused by multiple causative factors. It is difficult to control local infection due to its possible combination of bronchopleural fistula (BPF) and residual bone.The relevant literature emphasizes some risk factors for empyema progression after pneumonectomy, while the correlation between empyema and BPF after pneumonectomy increases mortality by infecting the remaining lungs. After pneumonectomy, the lung function of the contralateral side is particularly important. Case presentation This paper reports a 62-year-old male patient who underwent right pneumonectomy for squamous cell carcinoma of the lung 12 years ago and began to develop empyema with anterior chest wall sinus 3 years ago. After admission, chest computed tomography (CT) showed right pleural effusion and formation of chest wall sinus. According to his clinical symptoms and imaging examination, he was diagnosed as chronic empyema with chest wall sinus.Due to the huge residual cavity of the patient,the clinical effect of using free vastus lateralis myocutaneous flap combined with pedicled pectoralis major muscle flap to fill the abscess cavity was satisfactory,but acute respiratory failure occurred due to left lung aspiration pneumonia after operation. Conclusions After a series of treatment measures such as tracheal cannula, tracheotomy, anti-infection, maintenance of circulatory stability, and rehabilitation training, the patient was ultimately rescued and cured. Postoperative follow-up showed that the muscle flaps survived and empyema was eliminated.

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Section: Discussionmentioning

confidence: 99%

Salvage treatment of acute respiratory failure after autogenous tissue flap transplantation for chronic empyema with chest wall sinus: a case report and literature review

Wang,

Chen,

et al. 2024

J Cardiothorac Surg

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“…Open window thoracostomy (OWT) is widely used, and its safety and effectiveness have been affirmed by most thoracic surgeons. [ 21 , 22 ] It is one of the main surgical methods to control thoracic infection. Omentum and chest wall muscle packing, especially chest wall muscle packing, is increasingly accepted by thoracic surgeons, especially in patients with bronchial stump fistulas.…”

Section: Discussionmentioning

confidence: 99%

“…Omentum and chest wall muscle packing, especially chest wall muscle packing, is increasingly accepted by thoracic surgeons, especially in patients with bronchial stump fistulas. [ 21 , 22 ] Among the 5 patients, 3 patients completed the second-stage operation, the postoperative abscess filling effect was good, there was no recurrence during the follow-up period, and the chest tube was completely removed, which greatly improved the quality of life. The infection of the other 2 patients who had only one-stage operation was also effectively controlled, and the fistula disappeared in 1 patient, which met the patient’s preoperative treatment expectations.…”

Section: Discussionmentioning

confidence: 99%

Surgical operation combined with bronchoscopy in the treatment of fungal empyema: 5 cases report

Xin¹,

Wu²,

He³

et al. 2022

Medicine

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Rationale: Fungal empyema is a chronic refractory disease. It is difficult to control thoracic infection, and it is faced with the problem of recurrence. How to control the infection and reduce the probability of recurrence is a difficult problem. Surgical operation combined with endobronchial therapy was used to control infection, seal the fistula and eliminate residual cavity and achieved good results. Patient concerns: A total of 5 patients with fungal empyema were treated from 2019 to 2021, aged 27 to 72 years, with an average age of 54.8 ± 7.6 years. Two cases were on the left side and 3 cases on the right side. Diagnosis: While meeting the diagnostic criteria of empyema, the diagnosis of fungus in pus culture or the discovery of fungus in deep tissue pathology confirmed the diagnosis of fungal empyema in the 5 cases. Interventions: Through surgical operations combined with bronchoscopy and individualized treatment, the infection was controlled, the fistulas were blocked, and the pus cavity was filled. Outcomes: After 11 to 30 months of follow-up, the muscle flap in the abscess cavity was mildly atrophied, and there was no recurrence of empyema. Three patients who completed the second-stage operation had their chest tubes removed and returned to normal life. The 2 patients who did not complete the second-stage operation had no recurrence of thoracic infection and no recurrence of cough or fever, and their quality of life was greatly improved. Lessons: Surgical operation combined with bronchoscopy is a reliable method for the treatment of fungal empyema, which can find and plug the fistula more efficiently and eliminate the residual cavity by surgery to avoid recurrence. Therefore, it is a recommended treatment method.

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Aspergillus pleural empyema in a chronic smoker – A case report and review of literature

Chang

Kim

Jurado

et al. 2022

Journal of Medical Mycology

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Extended latissimus dorsi chimeric thoracoplasty with a vascular supercharge for Aspergillus empyema

Cited by 4 publications

References 4 publications

Salvage treatment of acute respiratory failure after autogenous tissue flap transplantation for chronic empyema with chest wall sinus: a case report and literature review

Salvage treatment of acute respiratory failure after autogenous tissue flap transplantation for chronic empyema with chest wall sinus: a case report and literature review

Surgical operation combined with bronchoscopy in the treatment of fungal empyema: 5 cases report

Aspergillus pleural empyema in a chronic smoker – A case report and review of literature

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