Post‐pneumonectomy empyema: Current management strategies

Ng, Calvin S.H.; Wan, Song; Lee, Tak Wai; Wan, Innes Y.P.; Arifi, Ahmed A.; Yim, Anthony P.C.

doi:10.1111/j.1445-2197.2005.03417.x

Cited by 23 publications

(20 citation statements)

References 38 publications

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“…Diğer serilerde daha önceki ameliyat veya adjuvan radyoterapiye bağlı olarak ortaya çıkan yoğun hiler ve intraperikardiyal yapışıklıklar mortaliteyi arttıran faktörler arasında bulunmuştur (19) . Diabetes mellitus, neoadjuvan tedavi, uzamış postoperatif mekanik ventilasyon uygulaması, sistemik hastalıklar, rezeksiyon sırasında bronş güdüğünün uzun bırakılması, bronş güdüğünde rezidüel tümör bulunması ve tamamlayıcı pnömonektomiler BPF oluşma riskini arttırmaktadır (20) . Serimizde diabetes mellitus ile neoadjuvan tedavinin BPF gelişimine etkisini irdeledik ve yalnızca neoadjuvan tedavinin BPF gelişimini anlamlı derecede arttırdığını tespit ettik.…”

Section: Discussionunclassified

Retrospective Analysis of Hundred Patients who had Undergone Lobectomy for Lung Cancer

Sagiroglu¹,

Meydan²,

Iskenderoğlu³

et al. 2013

GKDA Derg

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ÖZET Amaç (1) . In this study, we investigated the risk factors that extend the duration of postoperative unit stay or increase the morbidity and mortality. Material and Methods: GİRİŞHer yıl 26000 akciğer kanseri olgusunun tespit edildiği Kuzey Amerika'da, olguların % 87'si hastalıklar-dan dolayı ölmekte, ancak % 13'ü tedavi edilmektedir (2) . Perioperatif morbidite ve mortalitenin en büyük nedeni solunumsal komplikasyonlar olup, insidansı

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Section: Discussionunclassified

Retrospective Analysis of Hundred Patients who had Undergone Lobectomy for Lung Cancer

Sagiroglu¹,

Meydan²,

Iskenderoğlu³

et al. 2013

GKDA Derg

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“…It is observed more often after pneumonectomy, with an estimated incidence of 2-16%; the main risk factor is the bronchopleural fistula (20). It is less common after lobectomy and in this case it is often associated with the presence of residual pleural space.…”

Section: Empyemamentioning

confidence: 99%

Radiological contribution to the diagnosis of early postoperative complications after lung resection for primary tumor: a revisional study

Cardinale¹,

Priola²,

Priola³

et al. 2016

J. Thorac. Dis.

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In the post-operative course of the interventions of lung resection for primary tumor, complications of different nature and severity can arise, recognizing different pathogenetic mechanisms and differing according to the type of resection performed and to the time elapsed after surgery. The low diagnostic accuracy of chest radiography requires a thorough knowledge of the radiologist about all radiographic findings, both normal and pathological, which can be found in the immediate post-operative period (within 30 days after surgery). This article aims to describe the incidence, the clinical features and the radiological aspects of immediate complications following pulmonary resections, with specific reference to those in which the diagnostic imaging provides a fundamental contribution. important role in the surveillance of patients undergoing lung resection for primary tumor (3,4). This work aims to describe the incidence, clinical and radiological aspects of immediate complications that may arise after resection for primitive lung neoplasm, with specific reference to those in which imaging is able to provide an effective diagnostic contribution. Description of immediate complicationsIn patients undergoing surgical treatment for non-small cell lung cancer (NSCLC) the first post-operative period can be divided into two phases, immediate and early. The two phases differ substantially from each other in relation to the different clinical conditions of the patients and to the different management. In fact, the different clinical conditions and management of patients affects the choice of the radiological technique. In the immediate post-operative course, study of the patient is carried out essentially in the ward and it is therefore limited-both in normal course or in the presence of complications-in obtaining radiographs, performed with portable equipment (only in selected cases can be employed chest sonography or CT); the radiologist plays a central role in the early diagnosis of post-operative complications (5). Patients who underwent greater anatomic resection (pneumonectomy, bilobectomy and lobectomy) are monitored radiologically initially with bedside chest radiographs, and then with the two standard chest radiographs acquired with the patient in the upright position. The timing provides a radiological control in first and second post-operative day, then at the removal of the former and second drainage (after lobar or bilobar resection) in fourth and fifth post-operative day, at discharge and then at varying intervals depending on the clinical evolution. In patients undergoing sublobar resection (segmental or atypical) monitoring is less frequent, with X-rays performed in first post-operative day, at removal of the single drainage (3-4 post-operative days), at discharge and later in accordance with the clinical evolution. Not infrequently, the radiographic finding is difficult to be interpreted and the distinction between normal evolution and the onset of post-surgical complications may be uncertain....

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“…Cyanoacrylate glue is mixed with lipiodol for endobronchial injections into the submucosal layer of the proximal end of the bronchopleural fistula, raising the mucosa and thereby reducing the diameter of the fistula. The success rate of bronchoscopic closure of postlung-resectional bronchopleural fistula (,0.5 cm in diameter) using this technique in selected patients was 83% [3]. The images shown (figs 1 and 2) are from a 62-yr-old male with left post-pneumonectomy bronchopleural fistula treated with glue and lipiodol injections, and Dumon stent to the right main bronchus, after failed surgical repair of the fistula.…”

Section: To the Editorsmentioning

confidence: 99%

“…We recently described the novel management of postpneumonectomy empyema with bronchopleural fistula using bronchoscopic glue injection [3,4]. Cyanoacrylate glue is mixed with lipiodol for endobronchial injections into the submucosal layer of the proximal end of the bronchopleural fistula, raising the mucosa and thereby reducing the diameter of the fistula.…”

Section: To the Editorsmentioning

confidence: 99%

“…Embolisation of cement following percutaneous application and, indeed, embolisation of other foreign material (for example, cyanoacrylate glue and sclerotherapy agents) following endoscopic injection of gastric or oesophageal varices is well recognised [2].We recently described the novel management of postpneumonectomy empyema with bronchopleural fistula using bronchoscopic glue injection [3,4]. Cyanoacrylate glue is mixed with lipiodol for endobronchial injections into the submucosal layer of the proximal end of the bronchopleural fistula, raising the mucosa and thereby reducing the diameter of the fistula.…”

mentioning

confidence: 99%

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Iatrogenic causes of hilar radiopaque densities

Ng¹,

Lee²,

Yim³

2005

Eur Respir J

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To the Editors:We read with interest the case by VANDOOREN et al. [1], which highlighted one unusual cause of iatrogenic lung hilar densities. Embolisation of cement following percutaneous application and, indeed, embolisation of other foreign material (for example, cyanoacrylate glue and sclerotherapy agents) following endoscopic injection of gastric or oesophageal varices is well recognised [2].We recently described the novel management of postpneumonectomy empyema with bronchopleural fistula using bronchoscopic glue injection [3,4]. Cyanoacrylate glue is mixed with lipiodol for endobronchial injections into the submucosal layer of the proximal end of the bronchopleural fistula, raising the mucosa and thereby reducing the diameter of the fistula. The success rate of bronchoscopic closure of postlung-resectional bronchopleural fistula (,0.5 cm in diameter) using this technique in selected patients was 83% [3]. The images shown (figs 1 and 2) are from a 62-yr-old male with left post-pneumonectomy bronchopleural fistula treated with glue and lipiodol injections, and Dumon stent to the right main bronchus, after failed surgical repair of the fistula. The radiopaque lipiodal glue mixture is occluding the left bronchopleural fistula with spillage into the left pleural cavity, which highlights the muscle transposition flap. Clinicians should be aware of this form of bronchoscopic therapy, and recognise it as another cause of iatrogenic hilar radiopaque densities. Pulmonary embolization of 2-octyl cyanoacrylate after endoscopic injection therapy for gastric variceal bleeding.

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Post‐pneumonectomy empyema: Current management strategies

Cited by 23 publications

References 38 publications

Retrospective Analysis of Hundred Patients who had Undergone Lobectomy for Lung Cancer

Retrospective Analysis of Hundred Patients who had Undergone Lobectomy for Lung Cancer

Radiological contribution to the diagnosis of early postoperative complications after lung resection for primary tumor: a revisional study

Iatrogenic causes of hilar radiopaque densities

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