Epidemiology, Etiology and Prevention of Postpneumonectomy Pleural Empyema
| Autor: | Dragan Subotic, Evgeni Mekov, Danail Petrov, Dinko Valev, Georgi Yankov |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
bronchopleural
medicine.medical_specialty medicine.medical_treatment Fistula Bronchopleural fistula lcsh:Medicine Surgical Flaps Pneumonectomy Postoperative Complications medicine Humans Empyema Pleural Sutures business.industry Pleural empyema lcsh:R Postoperative complication General Medicine respiratory system medicine.disease Empyema Surgery respiratory tract diseases Chest tube postpneumonectomy pleural empyema business Complication |
| Zdroj: | Folia Medica, Vol 61, Iss 3, Pp 352-357 (2019) |
| ISSN: | 0204-8043 1314-2143 |
| Popis: | Background: Pleural empyema after pneumonectomy still poses a serious postoperative complication. A broncho-pleural fistula is often detected. Despite various therapeutic options developed over the last five decades it remains a major surgical challenge. Materials and methods: A literature search in MEDLINE database was carried out (accessed through PubMed), by using a combination of the following key-words and MeSH terms: pneumonectomy, postoperative, complications, broncho-pleural fistula, empyema, prevention. The following areas of intervention were identified: epidemiology, etiology, prevention. Results: Pleural empyema in a post-pneumonectomy cavity occurs in up to 16% of patients with a mortality of more than 10%. It is associated with broncho-pleural fistula in up to 80% of them, usually in the early postoperative months. Operative mortality could reach 50% in case of broncho-pleural fistula. Unfavourable prognostic factors are: benign disease, COPD, right-sided surgery, neoadjuvant and adjuvant therapy, time of chest tube removal, long bronchial stump and mechanical ventilation. Bronchial stump protection with vascularised flaps is of utmost importance in the prevention of complications. Conclusion: Postpneumonectomy pleural empyema is a common complication with high mortality. The existing evidence confirms the role of bronchopleural fistula prevention in the prevention of life-threatening complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|