The Role of Intrathoracic Free Flaps for Chronic Empyema

Walsh, Mark D.; Bruno, Anthony; Onaitis, Mark W.; Erdmann, Detlev; Wolfe, Walter G.; Toloza, Eric M.; Levin, L. Scott

doi:10.1016/j.athoracsur.2010.10.019

Cited by 30 publications

(17 citation statements)

References 11 publications

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“…In some cases of prolonged BPF where chronic empyema becomes a significant complication, major thoracic interventions would be necessary. Examples of such surgical techniques include thoracoplasty with operative removal of part of the skeletal support of the chest [9] and the use of intrathoracic free muscular flaps [10]. Thoracic surgeries, especially in severely ill patients, usually have heavy morbidity, mortality, and a hefty financial toll.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial Valves in the Management of Broncho-Pleural and Alveolo-Pleural Fistulae

El-Sameed

Waness

Shamsi

et al. 2012

Lung

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Pneumothorax from bronchopleural or alveolo-pleural fistulae can be complicated by prolonged air leak (AL). This can occur in a variety of clinical settings. Examples include structural lung disease, such as bronchiectasis, and cavitary lung disorders. Prolonged AL is associated with prolonged hospital stay, atelectasis, pneumonia, and thromboembolic disease. Endobronchial valves (EBVs) have been recently introduced to manage such situations. The global experience in this novel therapeutic modality is still evolving. We report our preliminary experience with managing persistent AL treated successfully with EBVs and review the current literature on this subject. Our experience shows that EBVs are an effective tool for the management of prolonged AL from persistent bronchopleural or alveolo-pleural fistulae. It is a minimally invasive procedure recommended as an option, particularly in patients not fit for surgical repair.

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Section: Discussionmentioning

confidence: 99%

Endobronchial Valves in the Management of Broncho-Pleural and Alveolo-Pleural Fistulae

El-Sameed

Waness

Shamsi

et al. 2012

Lung

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“…The main goals of treatment for empyema following BPF include calming down the infection, closing the BPF, and filling the dead space due to empyema. 3,4 Additional goals in cases of PAP and empyema following BPF are rescuing the patient from hemorrhagic shock and preventing rebleeding. In the present case, we were able to achieve temporary hemostasis via manual pressure because of the thoracostomy.…”

Section: Discussionmentioning

confidence: 99%

A Case of Bleeding Pulmonary Artery Pseudoaneurysm Successfully Treated with Emergency Microsurgery

Saito

Sakuraba

Kurosawa

et al. 2016

J Reconstr Microsurg Open

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Pulmonary artery pseudoaneurysm (PAP) is a rare condition. Reported causes of PAP include chest trauma, catheterization, and inflammatory diseases, such as pneumonia and lung abscess. 1 We report a bleeding PAP successfully treated with emergency microsurgical reconstruction. Case Presentation A 50-year-old man with T3N1M0 lung cancer of the right upper lobe underwent right upper and middle lobectomy, inferior lobe S6 segmentectomy, and lymph node dissection. Dehiscence of

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“…Sometimes the BPF is associated with empyema or infected pleural space; even in those cases, use of intercostal muscle flaps is associated with favorable outcome because of the good vascularity and autologus nature of the flap thereby increasing the chances of healing. Free flaps[ 9 ] have also been described in cases like redo surgery where pedicled flaps have already been used or are of insufficient length. Free flaps are more technically demanding procedures than pedicled flaps.…”

Section: Discussionmentioning

confidence: 99%

Intercostal muscle flap for repair of bronchopleural fistula

2015

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A 50-year-old male patient, a known case of chronic obstructive pulmonary disease (COPD), presented with the features of bronchopleural fistula (BPF) on the right side for 1 month. The patient was a chronic smoker and did not give any history suggestive of pulmonary Koch's. The patient had sudden-onset breathlessness and chest pain 1 month before, which was diagnosed to be due to spontaneous pneumothorax. An intercostal drain was inserted but even after 1 month of all conservative measures, the lung remained collapsed and there was large air leak in the intercostal drain. Computed tomogram (CT) of the chest revealed collapsed and entrapped lung with surgical emphysema of the subcutaneous tissues due to rupture of the emphysematous bulla on the right side along with the presence of emphysematous bullae on the left upper lobe also. Surgical intervention in the form of decortication of entrapped lung and repair of the BPF with intercostal muscle flap was performed. The patient recovered well and was discharged after 10 days.

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The Role of Intrathoracic Free Flaps for Chronic Empyema

Cited by 30 publications

References 11 publications

Endobronchial Valves in the Management of Broncho-Pleural and Alveolo-Pleural Fistulae

Endobronchial Valves in the Management of Broncho-Pleural and Alveolo-Pleural Fistulae

A Case of Bleeding Pulmonary Artery Pseudoaneurysm Successfully Treated with Emergency Microsurgery

Intercostal muscle flap for repair of bronchopleural fistula

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