[Computerized modelling of operation (CMO) before thoracoplasty]. / Thoraco-myoplastica mutéteink számítógépes modellezése és tervezése.

INTRODUCTION: Thoraco-myoplasty (TMP) has proven to be the only successful method of treatment for severe cases of chronic pyothorax (CPT). Great loss of muscle tissue and permanent bone-structure defects with severe functional damage can be caused by this method. The aim of the applied CMO was to prevent additional loss of muscle function. Preoperative evaluation of spiral CT scan 3-dimensional imaging provided a significant aid in decreasing adverse effects of the TMP. MATERIALS AND METHOD: Between 1990 and 2010, TMP was applied in 85 patients, whose CPT came from several different origins. CLINICAL DATA: average age: 62.7; mortality: 4.8%. Tissue and function preserving TMP was achieved following open treatment after thoracic fenestration in 76 cases, and drainage with continuous suction was performed in 9 patients prior to this. In our department TMP with computerized modeling was introduced as the definitive treatment of CPT in 2006, since then it has been applied in 8 patients. RESULTS: The number and length of the ribs to be resected can be anticipated applying spiral CT imaging. Furthermore, accurate volume measurement of the empyema cavity and rotatable muscles (pectoral major and latissimus dorsal) faciliatates elimination of the primary defect during surgery. CONCLUSION: Therefore, we believe that CMO can provide significant aid for surgeons to reduce the negative effects caused by muscle trauma and the structural changes in the thoracic wall.

[Vacuum assisted closure (VAC) of pyothorax with bronchial fistula following radiotherapy, pneumonectomy and thoraco-myoplasty]. / Irradiatiót és pneumonectomiát követo hörgosipolyos empyema thoracis nyitott, vákuumtámogatott (VAC) kezelése thoraco-myoplastica után.

Pulmonary fibrosis and impeding gangrene as complications of radiotherapy and chemotherapy developed in a patient who previously underwent right upper lobectomy. Following completion pneumonectomy, bronchopleural fistula and consecutive thoracic empyema formed. This case presentation is to demonstrate the vicious circle of severe complications following oncological treatment. The role of vacuum assisted closure and other management options are discussed which resulted in full recovery of the patient after three years finally.

[Simultaneous treatment of bilateral pneumothorax with videothoracoscopic surgery (VATS)]. / Kétoldali légmell egyidejû mûtéti kezelése videothoracoscopos (VATS) mûtéttel.

The authors report a simultaneous treatment of bilateral pneumothorax by videoscopic operation in a young male patient. An endoscopic stapler played an important role in the success of the operation. The authors claim that videothoracoscopic treatment (VATS) for bilateral pneumothorax is a faster and more effective way of treatment than the previous ones. This method significantly decreases the risks and the postoperative complications; in particular, in a case of bilateral pneumothorax.