Surgical outcomes and the factors affecting lung expansion following open window thoracostomy in chronic tuberculous empyema with destroyed lung

Dantis, Klein; Dewan, Ravindra Kumar

doi:10.1177/02184923221104431

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…Its pathogenic substances are mainly endotoxin, exotoxin and proteolytic enzymes. Its pathogenic characteristic is to cause secondary infection, which mostly occurs when the body's immunity is reduced [ 8 ]. Therefore, we need to design a surgical method that can completely solve these problems and achieve one-stage cure [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Autologous myocutaneous flap implantation for chronic refractory chest wall sinus with infection: a case report

Wang

Liu

et al. 2023

J Cardiothorac Surg

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Background Chest wall sinus with infection is a refractory disease caused by a variety of susceptible factors, and the treatment is still challenging. For clinically complex cases, although there are various surgical methods to choose from, it is still very difficult to achieve clinical cure, especially for patients with older age and many underlying diseases. Complete resection of chest wall sinus and application of repair and reconstruction technology may bring hope to refractory cases. Case presentation Herein, we report a case of a 67 year-old woman who had undergone breast cancer surgery and a history of multiple cycles of radiotherapy and chemotherapy. One year ago, she had a fistula in the left chest wall with yellow purulent fluid. After admission to our hospital, chest computed tomography (CT) showed the formation of the left chest wall sinus, accompanied by high-density images of the left clavicle, part of the ribs and part of the sternu. According to the patient's symptoms, signs and imaging examination, we preliminarily diagnosed the patient as chest wall sinus with infection and chronic osteomyelitis. Therefore, in the first-stage operation, the patient underwent left chest wall sinus resection, left partial rib resection, left partial clavicular resection and left partial sternal resection, After surgery, the wound surface was changed with gauze dressing with sensitive antibiotic solution every day until the wound surface was clean and new granulation was formed. In the second-stage operation, the wound surface was appropriately expanded, and the pedicled latissimus dorsi myocutaneous flap was transferred to the chest wall defect. Finally, the skin paddle was sutured without tension to the normal skin around the chest, and two drainage tubes were placed. Anti-infection, anti-spasm, anti-coagulation and other treatments were given after operation, and the survival of myocutaneous flap, wound healing and sinus disappearance were observed. Conclusion The application of pedicled latissimus dorsi myocutaneous flap in the treatment of intractable chronic chest wall sinus is an effective method. It does not change the shape of the thorax. The clinical effect is satisfactory in the near and medium term, which is worthy of clinical promotion.

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Section: Discussionmentioning

confidence: 99%

Autologous myocutaneous flap implantation for chronic refractory chest wall sinus with infection: a case report

Wang

Liu

et al. 2023

J Cardiothorac Surg

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“…Open-window thoracostomy is a simple, certain, and last resort drainage procedure for thoracic empyema[ 15 , 16 ]. It is the best means to drain purulent effusion caused by empyema from the pleural space and is an excellent interim treatment for BPF[ 17 , 18 ]. Furthermore, intrapleural irrigations of amphotericin B have been proven effective in preventing the recurrence of lung aspergillomas[ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Successful surgical treatment of bronchopleural fistula caused by severe pulmonary tuberculosis: A case report and review of literature

Shen¹,

Jiang²,

Dai³

2023

World J Clin Cases

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BACKGROUND Bronchopleural fistula (BPF) is a relatively rare, but severe complication of pulmonary tuberculosis. It is associated with significant mortality; however, its management remains a major therapeutic challenge. CASE SUMMARY We present a 24-year-old man with BPF resulting from severe pulmonary tuberculosis combined with mixed infections. The damaged right upper lobe and concomitant empyema were demonstrated via computed tomography. After undergoing open-window thoracostomy and tuberculosis treatment for 4 mo, decortication and right upper lobectomy were subsequently performed, leading to the resolution of tuberculosis and other concurrent pulmonary infections. Follow-up, 6 mo after surgery, failed to reveal any evidence of infection recurrence resulting in a good prognosis. CONCLUSION The disease course of tuberculous BPF is particularly challenging. Surgical intervention serves as an effective and safe therapeutic strategy for BPF.

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Surgical outcomes and the factors affecting lung expansion following open window thoracostomy in chronic tuberculous empyema with destroyed lung

Cited by 2 publications

References 12 publications

Autologous myocutaneous flap implantation for chronic refractory chest wall sinus with infection: a case report

Autologous myocutaneous flap implantation for chronic refractory chest wall sinus with infection: a case report

Successful surgical treatment of bronchopleural fistula caused by severe pulmonary tuberculosis: A case report and review of literature

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