Surgical approaches for bronchopleural fistula

Agnol, Guilherme Dal; Vieira, Arthur; Oliveira, Ricardo; Figueroa, Paula Antonia Ugalde

doi:10.21037/shc.2017.06.01

Cited by 13 publications

(30 citation statements)

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“…По данным Европейского общества торакальных хирургов (ESTS), частота несостоятельности культи главного бронха после пневмонэктомии составляет 1,8% [11]. Стандартизация лечения этой разнородной группы пациентов крайне сложна, в связи с этим до сих пор актуален опыт отдельных учреждений и публикации серий клинических наблюдений [12,13]. Алгоритм лечения пациентов с несостоятельностью культи бронха после пневмонэктомии включает 3 основные задачи: санацию плевральной полости, ликвидацию патологического бронхоплеврального соустья и устранение дефекта мягких тканей грудной клетки.…”

Section: Discussionunclassified

Transsternal occlusion of the main bronchus stump in bronchopleural fistula and non-specific pleural empyema

Pechetov¹,

Gritsuta²,

Esakov³

et al. 2019

Khir. Z. im. N.I. Pirogova

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Section: Discussionunclassified

Transsternal occlusion of the main bronchus stump in bronchopleural fistula and non-specific pleural empyema

Pechetov¹,

Gritsuta²,

Esakov³

et al. 2019

Khir. Z. im. N.I. Pirogova

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“…As Clagett procedure is multistep, prolonged and associated with high morbidity, the trans-sternal transpericardial approach which was initially described by Abruzzini is an option to avoid entering in a previously manipulated and diseased inflammatory cavity. 33,34,35 So, the author found dead space closed reduction thoracoplasty has operative equivalence with minimal untoward consequences and improved psychosocial health when compared with open window thoracostomy. Its implication in early young age group of chronic empyema thoracis patients is highly demanding.…”

Section: Discussionmentioning

confidence: 99%

Dead Space Reduction Closed Thoracoplasty in Chronic Empyema Thoracis Patients of Early Young Age Group

Sharma¹,

Gupta²,

Kaushal³

et al. 2018

jemds

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BACKGROUNDThe social stigma of chronic empyema thoracis treated with open window thoracostomy (OWT) has significant negative impact on psychosocial well-being, especially in early young age group patients. So, evaluation of better alternative of dead space reduction closed thoracoplasty method was done by the author. Aims and Objectives-To evaluate standard easily reproducible surgical method to cure and control chronic empyema thoracis other than open window thoracostomy in early young age group patients in central India. MATERIALS AND METHODSDead space reduction closed thoracoplasty was performed in 44 patients of chronic empyema thoracis between the age group of 13 and 25 years by conventional thoracoplasty (Alexander type), tailoring thoracoplasty and Schede thoracoplasty. Patients were evaluated in terms of weight gain, chest x-ray, air leak and column movement in ICD and pus culture sensitivity at regular intervals. Targeted dead space reduction is achieved excellently when column movement is less than 5 cm and acceptable when between 5 and 10 cm. Absence of air leak even on coughing (excellent) and only on coughing (acceptable) in patent intercostal drainage tube. Statistical Analysis-By student's t-test, repeated measure ANOVA test for difference of mean, confidence interval with standard error estimation, 'p' value and percentage also. Setting and Design-A hospital-based prospective longitudinal study as all the enrolled patients are followed up at designed time. RESULTSChronic empyema thoracis of 40 patients was cured and controlled with dead space reduction thoracoplasty, whereas 4 patients with multi-drug resistance tuberculosis (MDR TB) did not cure, so they further required other modalities. CONCLUSIONPatients with persistent infection and poor weight gain have high failure rate in dead space reduction closed thoracoplasty.

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“…If the leak is from the bronchus, the options are primary repair with or without patch repair. Patch repairs can involve the use of intercostal muscle, latissimus dorsi, omentum, pectoralis major, rectus abdominis or serratus anterior (21).…”

Section: Surgical Repairmentioning

confidence: 99%

Postoperative subcutaneous emphysema: prevention and treatment

Lodhia¹,

Tenconi²

2021

Shanghai Chest

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Post-operative subcutaneous (or surgical) emphysema (POSE) affects approximately six percent of patients undergoing thoracic surgery. Pre-operative forced expiratory volume in 1 second (FEV 1 ) and lung diffusion capacity for carbon monoxide (DLCO) poorer than 50% of predicted, the presence of adhesions and a post-operative air leak are predictive factors for post-operative subcutaneous emphysema. POSE leads to increased patient distress, dyspnoea, empyema and prolonged length of stay (LOS). The management of this condition should aim at ensuring that the lung is fully expanded through adequate drainage of the chest cavity, in order to expedite sealing of the parenchymal tear. This may require the use of low-pressure suction (−20 cmH 2 O) and pleurodesis techniques. Symptomatic relief can be achieved with sub-cutaneous drains or by applying negative pressure dressing [vacuum assisted closure (VAC) pump]. A small percentage of patients (approximately 1%) require a further surgical procedure to control the air leak.

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Surgical approaches for bronchopleural fistula

Cited by 13 publications

References 0 publications

Transsternal occlusion of the main bronchus stump in bronchopleural fistula and non-specific pleural empyema

Transsternal occlusion of the main bronchus stump in bronchopleural fistula and non-specific pleural empyema

Dead Space Reduction Closed Thoracoplasty in Chronic Empyema Thoracis Patients of Early Young Age Group

Postoperative subcutaneous emphysema: prevention and treatment

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