Descending necrotizing mediastinitis: a challenging infection. Selected results of a Moroccan bicentric study.

Autor: El Hammoumi M; Department of Thoracic Surgery, Military Teaching Hospital Mohammed V, Rabat, Morocco., Ouraini S; ORL Department, Military teaching Hospital Mohammed V, Rabat, Morocco., Bhairis M; Department of Thoracic Surgery, Military Teaching Hospital Mohammed V, Rabat, Morocco., Kouatli H; Department of Thoracic Surgery, Military Teaching Hospital Mohammed V, Rabat, Morocco., Kamdem KM; Department of Thoracic Surgery, Military Teaching Hospital Mohammed V, Rabat, Morocco., Kabiri EH; Department of Thoracic Surgery, Military Teaching Hospital Mohammed V, Rabat, Morocco.
Jazyk: angličtina
Zdroj: Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery [Kardiochir Torakochirurgia Pol] 2023 Jun; Vol. 20 (2), pp. 100-104. Date of Electronic Publication: 2023 Jul 26.
DOI: 10.5114/kitp.2023.129541
Abstrakt: Introduction: Mediastinal infection is a persistent and difficult widespread infectious disease caused by secondary complications of adjacent organs. It spreads easily and is often misdiagnosed because of the lack of typical manifestations.
Material and Methods: To highlight the clinical features, medical and surgical strategy of descending necrotizing mediastinitis we performed a retrospective study of 25 documented cases during a 10-year period at our hospital, all treated surgically, 10 from the ORL department and 15 from our thoracic surgery department.
Results: Patients were aged from 20 to 84 years, with a median age of 41 years, male predominance (19 men and 6 women), sex ratio of 3.6. A cervicotomy (in 40% of cases) was associated or not with videothoracoscopy (one case) or thoracotomy (in 20% of cases) and wide-spectrum antibiotherapy. In the postoperative period, an irrigation-suction system was used on the drains in 15 patients. In 1 case a rethoracotomy was necessary to remove a residual right pyothorax, and one patient required a tracheostomy. Twenty-two (88%) patients recovered from their mediastinitis. Death of 3 patients by sepsis multiorgan failure occurred. Postoperative follow-up during one year was uneventful without recurrence.
Conclusions: According to our experience, we believe the more aggressive local treatment is, the better are the results.
Competing Interests: The authors report no conflict of interest.
(Copyright: © 2023 Polish Society of Cardiothoracic Surgeons (Polskie Towarzystwo KardioTorakochirurgów) and the editors of the Polish Journal of Cardio-Thoracic Surgery (Kardiochirurgia i Torakochirurgia Polska).)
Databáze: MEDLINE
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