HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shamji, F. M. Articles by Pearson, F. G. Search for Related Content PubMed PubMed Citation Articles by Shamji, F. M. Articles by Pearson, F. G.

The Journal of Thoracic and Cardiovascular Surgery, Vol 86, 818-822, Copyright © 1983 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Open window thoracostomy in the management of postpneumonectomy empyema with or without bronchopleural fistula

FM Shamji, RJ Ginsberg, JD Cooper, EH Spratt, M Goldberg, PF Waters, R Ilves, TR Todd and FG Pearson

Postpneumonectomy empyema, with or without bronchopleural fistula, remains an infrequent but serious complication of pulmonary resection. We reviewed our experience with the Clagett procedure in 31 patients with postpneumonectomy empyema. Seven had empyema alone and 24 had empyema with bronchopleural fistula. Ten patients died of metastatic disease without attempted closure of the thoracostomy window. In eight patients the total Clagett procedure was completed; window closure was permanent in two patients, but the remaining six had recurrence of empyema (four of whom had persistent occult fistulas). In eight further patients, persistent infection prevented attempted closure of the window. Five patients refused further surgical procedures. In only two of 31 patients were we able to achieve permanent closure of the thoracostomy window. Based on this experience, we conclude that open window thoracostomy provides adequate drainage and an excellent interim or permanent treatment of the infected pneumonectomy space. However, the presence of persistent bronchopleural fistula prevents successful completion of the total Clagett procedure. In our series, there were no deaths related to empyema or the surgical procedures performed for it.

This article has been cited by other articles:

				A. Haghshenasskashani, M. Rahnavardi, T. D. Yan, and B. C. McCaughan Intrathoracic application of a vacuum-assisted closure device in managing pleural space infection after lung resection: is it an option? Interact CardioVasc Thorac Surg, August 1, 2011; 13(2): 168 - 174. [Abstract] [Full Text] [PDF]

				H. B. Ris, E. Pezzetta, T. Krueger, and D. Lardinois Surgical treatment of pleural infections: the surgeon's point of view Surgery for Non-Neoplastic Disorders of the Chest: a Clinical Update, June 28, 2010; 181 - 198. [Abstract] [Fulltext] [PDF]

				D. Schneiter, T. Grodzki, D. Lardinois, P. B. Kestenholz, J. Wojcik, B. Kubisa, J. Pierog, and W. Weder Accelerated treatment of postpneumonectomy empyema: A binational long-term study J. Thorac. Cardiovasc. Surg., July 1, 2008; 136(1): 179 - 185. [Abstract] [Full Text] [PDF]

				S. Zaheer, M. S. Allen, S. D. Cassivi, F. C. Nichols III, C. H. Johnson, C. Deschamps, and P. C. Pairolero Postpneumonectomy Empyema: Results After the Clagett Procedure Ann. Thorac. Surg., July 1, 2006; 82(1): 279 - 287. [Abstract] [Full Text] [PDF]

				F. Massera, M. Robustellini, C. D. Pona, G. Rossi, A. Rizzi, and G. Rocco Predictors of Successful Closure of Open Window Thoracostomy for Postpneumonectomy Empyema Ann. Thorac. Surg., July 1, 2006; 82(1): 288 - 292. [Abstract] [Full Text] [PDF]

				Y. Okumura, S.-i. Takeda, H. Asada, M. Inoue, N. Sawabata, H. Shiono, and H. Maeda Surgical Results for Chronic Empyema Using Omental Pedicled Flap: Long-Term Follow-Up Study Ann. Thorac. Surg., June 1, 2005; 79(6): 1857 - 1861. [Abstract] [Full Text] [PDF]

				M. Cappello and A. De Troyer Role of rib cage elastance in the coupling between the abdominal muscles and the lung J Appl Physiol, July 1, 2004; 97(1): 85 - 90. [Abstract] [Full Text] [PDF]

				D. Schneiter, P. Cassina, S. Korom, I. Inci, M. Al-Abdullatief, A. Dutly, P. Kestenholz, and W. Weder Accelerated treatment for early and late postpneumonectomy empyema Ann. Thorac. Surg., November 1, 2001; 72(5): 1668 - 1672. [Abstract] [Full Text] [PDF]

				J.-F. Regnard, M. Alifano, P. Puyo, E. Fares, P. Magdeleinat, and P. Levasseur Open window thoracostomy followed by intrathoracic flap transposition in the treatment of empyema complicating pulmonary resection J. Thorac. Cardiovasc. Surg., August 1, 2000; 120(2): 270 - 275. [Abstract] [Full Text] [PDF]

				M. de Perrot and A. Spiliopoulos Postpneumonectomy bronchopleural fistula Ann. Thorac. Surg., November 1, 1999; 68(5): 1886 - 1887. [Full Text] [PDF]

				P. Icard, J. P. Le Rochais, B. Rabut, S. Cazaban, B. Martel, and C. Evrard Andrews thoracoplasty as a treatment of post-pneumonectomy empyema: experience in 23 cases Ann. Thorac. Surg., October 1, 1999; 68(4): 1159 - 1163. [Abstract] [Full Text] [PDF]

				F. Gharagozloo, G. Trachiotis, A. Wolfe, K. J. DuBree, and J. L. Cox PLEURAL SPACE IRRIGATION AND MODIFIED CLAGETT PROCEDURE FOR THE TREATMENT OF EARLY POSTPNEUMONECTOMY EMPYEMA J. Thorac. Cardiovasc. Surg., December 1, 1998; 116(6): 943 - 948. [Abstract] [Full Text] [PDF]

				M. Garcia-Yuste, G. Ramos, J. L. Duque, F. Heras, M. Castanedo, L. J. Cerezal, and J. M. Matilla Open-Window Thoracostomy and Thoracomyoplasty to Manage Chronic Pleural Empyema Ann. Thorac. Surg., March 1, 1998; 65(3): 818 - 822. [Abstract] [Full Text] [PDF]

				D. Weissberg and Y. Refaely Pleural Empyema: 24-Year Experience Ann. Thorac. Surg., October 1, 1996; 62(4): 1026 - 1029. [Abstract] [Full Text]

				J. M. Serletti, R. H. Feins, A. J. Carras, J. E. Losee, D. W. Johnstone, H. R. Herrera, and G. L. Hicks Jr. OBLITERATION OF EMPYEMA TRACT WITH DEEPITHELIALIZED UNIPEDICLE TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS FLAP J. Thorac. Cardiovasc. Surg., September 1, 1996; 112(3): 631 - 636. [Abstract] [Full Text]

				H. Asamura, T. Goya, T. Naruke, R. Tsuchiya, H. Kondo, K. Suemasu, and T. Nakatsuka Closure of fenestra in clagett procedure: Use of rectus abdominis musculocutaneous flap Ann. Thorac. Surg., July 1, 1992; 54(1): 147 - 149. [Abstract] [PDF]

				T. Shirakusa, H. Ueda, S. Takata, S. Yoneda, K. Inutsuka, N. Hirota, and M. Okazaki Use of pedicled omental flap in treatment of empyema Ann. Thorac. Surg., September 1, 1990; 50(3): 420 - 424. [Abstract] [PDF]

				B. A. Keagy, M. E. Lores, P. J. K. Starek, G. F. Murray, C. L. Lucas, and B. R. Wilcox Elective Pulmonary Lobectomy: Factors Associated with Morbidity and Operative Mortality Ann. Thorac. Surg., October 1, 1985; 40(4): 349 - 352. [Abstract] [PDF]

				R. A. Hopkins, R. M. Ungerleider, E. W. Staub, and W. G. Young Jr. The Modern Use of Thoracoplasty Ann. Thorac. Surg., August 1, 1985; 40(2): 181 - 187. [Abstract] [PDF]