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Pedicle muscle flap transposition for chronic empyema with persistent bronchopleural fistula: experience of a single clinical center in China

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Abstract

Purpose

The management of chronic empyema with persistent bronchopleural fistula (BPF) is a major challenge for surgeons. We report our experience of performing pedicle muscle flap transposition for chronic empyema with BPF in a clinical center in China.

Methods

The subjects of this study were 13 patients with postoperative chronic empyema and persistent BPF. The surgical procedure performed was chosen according to the degree of infection in the empyema cavity. Patients with mild contamination underwent one-stage cavity decortication with flap transposition, whereas patients with severe infection underwent two-stage surgery including open-window thoracostomy and pedicle muscle flap transposition.

Results

Five patients underwent one-stage surgery, followed by an uneventful postoperative course in all except one. The other eight patients underwent two-stage surgery. The fistulas closed spontaneously during the course of dressings and six of these eight patients underwent second-stage surgery uneventfully. A bronchopleurocutaneous sinus developed in the wounds of the other two patients.

Conclusions

Pedicle muscle flap transposition is a viable option for chronic empyema with BPF; however, surgical procedures should be selected according to the degree of contamination. For two-stage surgery, obliteration of the cavity should be considered, preferably after closure of the fistula.

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Abbreviations

BPF:

Bronchopleural fistula

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Acknowledgments

This study was supported by the Clinical Foundation of Shanghai (134119a1600), the National Natural Science Foundations of China (81302099, 81372313) and ZHUOXUE program of Fudan University.

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Author notes

    Authors and Affiliations

    1. Department of Thoracic Surgery, Fudan University Zhongshan Hospital, Fenglin Road 180, Shanghai, 200032, China

      Chunlai Lu, Di Ge, Yunfeng Yuan, Jie Gu & Fengkai Xu

    2. Department of Plastic and Reconstructive Surgery, Fudan University Zhongshan Hospital, Fenglin Road 180, Shanghai, 200032, China

      Zihao Feng, Yong Zhang & Fazhi Qi

    Authors
    1. Chunlai Lu
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    2. Zihao Feng
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    3. Di Ge
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    4. Yunfeng Yuan
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    5. Yong Zhang
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    6. Fazhi Qi
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    7. Jie Gu
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    8. Fengkai Xu
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    Corresponding authors

    Correspondence to Di Ge or Fazhi Qi.

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    Conflict of interest

    Chunlai Lu and co-authors have no conflicts of interest to declare.

    Additional information

    C. Lu and Z. Feng contributed equally to this manuscript.

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    Lu, C., Feng, Z., Ge, D. et al. Pedicle muscle flap transposition for chronic empyema with persistent bronchopleural fistula: experience of a single clinical center in China. Surg Today 46, 1132–1137 (2016). https://doi.org/10.1007/s00595-015-1288-y

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    • DOI: https://doi.org/10.1007/s00595-015-1288-y

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