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Postoperative pyothorax

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Abstract

Twenty-five cases of pyothorax occurred in a series of 1281 thoracotomies. Almost all cases of pyothorax without bronchopleural fistula were successfully treated by closed drainage and irrigation alone. On the other hand, patients with pyothorax and fistula who were treated only with closed drainage almost all had a poor outcome. When pyothorax with fistula was treated by closed drainage and irrigation followed by further procedures such as open window thoracostomy, muscle plombage and/or omentopexy, treatment was successful. It is concluded that pyothorax without fistula may be cured by closed drainage and irrigation alone, but that pyothorax with fistula requires operative intervention such as open window thoracostomy or omental flap as soon as possible.

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References

  1. Azorin J, Bah T, Renard JL, Saint-Florent G, Battesti JP (1988) Post-pneumonectomy pyothorax with or without bronchopleural fistula. Diagnosis and treatment. Rev Pneumol Clin 44:1–5

    Google Scholar 

  2. Adebo OA, Osinowo O (1987) Management of empyema and bronchial fistula. Trop Doct 17:26–29

    Google Scholar 

  3. Dorman JP, Campbell D, Grover FL, Trinkel K (1973) Open thoracostomy drainage of postpneumonectomy empyema with bronchial fistula. J Thorac Cardiovasc Surg 66:979–981

    Google Scholar 

  4. Hurvitz RJ, Tucker BL (1986) The Eloesser flap: Past and present. J Thorac Cardiovasc Surg 92:958–961

    Google Scholar 

  5. Weissberg D (1982) Empyema and bronchial fistula. Chest 82:447–450

    Google Scholar 

  6. Virkkula L, Eerola S (1975) Use of omental pedicle for treatment of bronchial fistula after lower lobectomy. Scand J Thorac Cardiovasc Surg 9:287–290

    Google Scholar 

  7. Adlay ES, Goldsmith HS (1972) Surgical technique for omental lengthening based on arterial anatomy. Surg Gynecol Obstet 135:103–107

    Google Scholar 

  8. Malave G, Foster ED, Wilson JA, Munro DD (1971) Bronchial Fistula — Present study of an old problem. Ann Thorac Surg 11:1–10

    Google Scholar 

  9. Nagasaki F, Fleinger BJ, Martini N (1982) Complications of surgery in the treatment of carcinoma of the lung. Chest 82:25–9

    Google Scholar 

  10. Lima O, Goldberg M, Peters WJ, Ayabe H, Townsend E, Cooper JD (1982) Bronchial omentopexy in canine lung transplantation. J Thorac Cardiovasc Surg 83:418–421

    Google Scholar 

  11. Jessen C, Sharma P (1985) Use of fibrin glue in thoracic surgery. Ann Thorac Surg 39:521–524

    Google Scholar 

  12. Hoier-Madsen K, Schulze S, Pedersen VM, Halkier E (1984) Management of bronchopleural fistula following pneumonectomy. Scand J Thorac Cardiovasc Surg 18:263–266

    Google Scholar 

  13. Gregoire R, Deslauriers J, Beaulieu M, Piraux M (1987) Thoracoplasty: Its forgotten role in the management of non-tuberculous postpneumonectomy empyema. Canadian J Surg 30:343–345

    Google Scholar 

  14. Iioka S, Sawamura K, Mori T, Iuchi K, Nakamura K, Monden Y, Kawashima Y (1985) Surgical treatment of chronic empyema. J Thorac Cardiovasc Surg 90:179–185

    Google Scholar 

  15. Graham EA (1924) Principle involved in the treatment of acute and chronic empyema. Surg Gynecol Obstet 38:466–470

    Google Scholar 

  16. Eerola S, Virkkula L, Varstela E (1988) Treatment of postpneumonectomy empyema and associated bronchopleural fistula. Scand J Tho Cardiovasc 22:235–239

    Google Scholar 

  17. Hankins JR, Miller JE, McLaughlin JS (1978) The use of chest wall flaps to close bronchopleural fistulas: Experience with 21 patients. Ann Thorac Surg 25:491–499

    Google Scholar 

  18. Miller JI, Mansour KA, Nahai F, Jurkiewicz MJ, Hatcher CR Jr (1984) Single-stage complete muscle flap closure of the postpneumonectomy empyema space: A new method and possible solution to a disturbing complication. Ann Thorac Surg 38:227–231

    Google Scholar 

  19. Pairolero PC, Arnold PG, Piehler JM (1983) Intrathoracic transposition of extrathoracic skeletal muscle. J Thorac Cardiovasc Surg 86:809–817

    Google Scholar 

  20. Clagett OT, Geraci JE (1963) A procedure for the management of postpneumonectomy empyema. J Thorac Cardiovasc Surg 45:141–145

    Google Scholar 

  21. Bayes AJ, Wilson JAS, Chiu RCJ, Errett LE, Hedderich G, Munro DD (1987) Clagett open-window thoracostomy in patients with empyema who had and had not undergone pneumonectomy. Can J Surg 30:329–331

    Google Scholar 

  22. Goldsmith HS, Santos R, Vanamee P, Beatie EJJ (1968) Experimental protection of vascular prosthesis by omentum. Arch Surg 97:872–878

    Google Scholar 

  23. Alli I, Unruh H (1990) Management of empyema thoracis. Ann Thorac Surg 50:355–359

    Google Scholar 

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Ueda, H., Shibata, K. & Kusano, T. Postoperative pyothorax. Surg Today 22, 115–119 (1992). https://doi.org/10.1007/BF00311334

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  • DOI: https://doi.org/10.1007/BF00311334

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