“Empyemas” of the Thoracic Cavity in the Hippocratic Corpus

Christopoulou-Aletra, Helen; Papavramidou, Niki

doi:10.1016/j.athoracsur.2007.11.031

Cited by 47 publications

(35 citation statements)

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“…Since then there have been various points of debates and arguments over thoracic drainage. [1] The debate between open and closed chest drainage persisted for centuries. There have been various great surgeons on either side of the pedestal each insisting that their method was better.…”

Section: Discussionmentioning

confidence: 99%

Re-discovering the heimlich valve: Old wine in a new bottle

2017

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A 14-year-old boy came to our outpatient department with pleuritic chest pain and dyspnea. He was found to have a loculated empyema on the right side. He was taken up for surgery and decortication was done. He developed air leak in the postoperative period. When the air leak did not settle until the 10th day, we decided to attach the atrium Pneumostat™, a modified version of the Heimlich valve to his Intercostal drainage tube and sent him home. On further follow-up, his lung expanded, and ICD could be removed. The patient remains well until the current follow-up. We present this case in an attempt to change the perceptions about various options available to drain the chest. The Heimlich valve appears to be a more compliant option than the conventional underwater seal drainage in terms of early mobility, reduced length of stay, and patient compliance.

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Section: Discussionmentioning

confidence: 99%

Re-discovering the heimlich valve: Old wine in a new bottle

2017

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“…Empyema is known since Hippocrates, who described the clinical signs and recommended open drainage using cautery [6]. However, lack of knowledge about the pleural physiology made difficult the early attempts of surgical treatment.…”

Section: Historical Backgroundmentioning

confidence: 99%

Thoracomyoplasty in the Treatment of Empyema: Current Indications, Basic Principles, and Results

Botianu

2012

Pulmonary Medicine

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Empyema remains a challenge for modern medicine. Cases not amenable to lung decortication are particularly difficult to treat, requiring prolonged hospitalizations and mutilating procedures. This paper presents the current role of thoracomyoplasty procedures, which allow complete and definitive obliteration of the infected pleural space by a combination of thoracoplasty and the use of neighbourhood muscle flaps (latissimus dorsi, serratus anterior, pectoralis, rectus abdominis, omentum, etc). Recent publications show an overall rate of success of 90%, with a quick and definitive healing. Although rarely indicated in our days, this kind of procedures remain in the armamentarium of modern thoracic surgery. The importance of thoracomyoplasty derives from the fact that it may be a simple and definitive solution for complicated cases of chronic empyema not amenable to standard decortication.

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“…The Hippocratic physicians fi rst referred to "empyema" between the fi fth and second centuries BC. 1 They realized that accumulation of pus into the chest causes symptoms and possibly death, and they recommended surgical drainage if the conservative methods fail. Although medical technologies have dramatically improved recently, the principles of empyema treatment proposed by the Hippocratic physicians are not yet obsolete.…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of chronic empyema

Shiraishi

2010

Gen Thorac Cardiovasc Surg

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Empyema remains challenging for thoracic surgeons. This review covers diverse aspects of acute empyema and chronic empyema and its surgical treatment. The triphasic nature of thoracic empyema (stages I, II, and III) is also addressed. The principles of empyema treatment are early diagnosis and early treatment. For acute empyema (empyema in stages I and II), early surgical intervention, such as video-assisted thoracoscopic débridement, is recommended when conventional chest tube drainage has failed. Radical treatments of chronic empyema (empyema in stage III) include (1) removal of the empyema space (decortication with or without lung resection) and (2) obliteration of the pleural space with muscle flaps or omentum flaps, or by thoracoplasty. Decortication is the procedure of choice for patients with reexpandable underlying lung. When bronchopleural fistula exists in the underlying lung, the fistula should be securely closed. For those patients whose underlying lung cannot be expected to reexpand, the procedure of choice is either concomitant removal of the affected lung with the empyema space or obliteration of the pleural space. For patients who are not eligible for the above-mentioned radical treatment, open-window thoracostomy can be considered. This procedure is not only performed as a definitive treatment of empyema but also as a preparatory treatment for radical procedures. Radical procedures are performed when patients recuperate. Choosing the most suitable operation based on the stages of empyema, the conditions of the underlying lung, and the conditions of a patient holds the key to success.

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“Empyemas” of the Thoracic Cavity in the Hippocratic Corpus

Cited by 47 publications

References 0 publications

Re-discovering the heimlich valve: Old wine in a new bottle

Re-discovering the heimlich valve: Old wine in a new bottle

Thoracomyoplasty in the Treatment of Empyema: Current Indications, Basic Principles, and Results

Surgical treatment of chronic empyema

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