| Autor: |
Bayes AJ; Department of Surgery, Montreal Chest Hospital Center, PQ., Wilson JA, Chiu RC, Errett LE, Hedderich G, Munro DD |
| Jazyk: |
angličtina |
| Zdroj: |
Canadian journal of surgery. Journal canadien de chirurgie [Can J Surg] 1987 Sep; Vol. 30 (5), pp. 329-31. |
| Abstrakt: |
Patients with empyema not responding to simple chest-tube drainage and antibiotic therapy have been managed by a "Clagett"-type procedure that consists of open-window thoracostomy, antibiotic irrigation and closure of the window. The results of such treatment were reviewed. Of the 103 patients with empyema treated between 1967 and 1983, 41 underwent open-window thoracostomy. Twenty-eight (group 1) had empyema after pneumonectomy, 13 (group 2) did not; however, 9 of the 13 in group 2 had undergone lobectomy. The mean follow-up was 46 months for group 1 and 42 months for group 2. When surgical closure of the open-window thoracostomy was attempted, the success rate in group 1 was 85% for those without concomitant bronchopleural fistula, but only 36% in patients with a fistula. In group 2 the respective success rates were 50% and 57%. Unsuccessful closure resulted in chronic fistulas in four patients in each of the two groups. Six deaths in group 1 and two in group 2 were related to the original disease, but one was an operative death. These results demonstrate both the effectiveness and limitations of open-window thoracostomy in the management of these difficult cases. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
|
