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1.
Kyobu Geka ; 74(6): 465-468, 2021 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-34059594

RESUMO

We report a case of a 64-year-old man with descending necrotizing mediastinitis. He had undergone ascending aortic replacement for Stanford type A acute dissection five years before, and thoracic endovascular aortic repair from the distal arch to the descending aorta for dilation of residual dissection three years before. The patient was admitted to our hospital complaining persistent fever, rubescent neck and chest. Computed tomography( CT) revealed a deep-seated mass extending between the neck and the right upper mediastinum and another mass around the ascending aorta graft. Computed tomography-guided drainage revealed infection of both masses. Surgical debridement, graft replacement, and omental flap transposition were performed. He recovered uneventfully, and no relapse of infection was observed.


Assuntos
Aneurisma Dissecante , Aneurisma da Aorta Torácica , Mediastinite , Aneurisma Dissecante/diagnóstico por imagem , Aneurisma Dissecante/cirurgia , Aorta , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Humanos , Masculino , Mediastinite/diagnóstico por imagem , Mediastinite/etiologia , Mediastinite/cirurgia , Pessoa de Meia-Idade
2.
Kyobu Geka ; 74(2): 121-124, 2021 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-33976017

RESUMO

We herein report two cases of pediatric poststernotomy mediastinitis treated by traction-assisted negative pressure wound therapy (NPWT) with Zip Surgical Skin Closure (Zip), which is a non-invasive skin closure device. We used this device with NPWT in cases of pediatric poststernotomy mediastinitis to stabilize the sternum and reduce the natural retractive forces of the skin. The patients were two boys (two and three months old), with an onset of infection at 13 and eight postoperative days, respectively. The culture examination detected methicillin-susceptible Staphylococcus aureus in both cases. Traction-assisted NPWT with Zip was performed at-75 mmHg for 16 and 33 days, and the wounds healed completely. In conclusion, this modification was successfully applied to treat pediatric poststernotomy mediastinitis and may help reduce the duration of treatment.


Assuntos
Mediastinite , Tratamento de Ferimentos com Pressão Negativa , Criança , Humanos , Lactente , Masculino , Mediastinite/cirurgia , Esterno , Infecção da Ferida Cirúrgica/terapia , Tração , Resultado do Tratamento
3.
Kyobu Geka ; 74(4): 313-316, 2021 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-33831893

RESUMO

The case was a 57-year-old woman. She visited a local doctor with a chief complaint of sore throat. A retropharyngeal abscess was suspected, and she was referred to our otolaryngology. Contrast-enhanced computed tomography(CT) scan revealed continuous fluid retention from the retropharyngeal space to the neck and the superior and posterior mediastinum with bilateral pleural effusion. The patient was diagnosed with descending necrotizing mediastinitis with empyema, and on the same day cervical drainage, thoracoscopic bilateral mediastinal drainage, empyema curettage and tracheostomy was performed. Postoperative contrast-enhanced CT scan revealed a widespread residual mediastinal abscess and thoracoscopic bilateral mediastinal drainage was performed again on the 11th postoperative day. After reoperation, the inflammation gradually subsided and she was discharged 47 days after reoperation.


Assuntos
Empiema , Mediastinite , Abscesso , Drenagem , Empiema/complicações , Empiema/diagnóstico por imagem , Empiema/cirurgia , Feminino , Humanos , Mediastinite/complicações , Mediastinite/diagnóstico por imagem , Mediastinite/cirurgia , Mediastino , Pessoa de Meia-Idade , Necrose
4.
Zentralbl Chir ; 146(S 01): S19-S25, 2021 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-33535266

RESUMO

INTRODUCTION: Descending necrotising mediastinitis (DNM) is a rare, but very severe, septic condition, caused by the spread of infection from the neck to the mediastinum. Delay in diagnosis and inadequate surgical procedures may lead to a life-threatening situation. MATERIAL: We retrospectively evaluated a group of patients who suffered from DNM and were treated in our department by mediastinal drainage in the last 10 years (2010 - 2019). All patients required one of the following methods of drainage: cervicomediastinal, mediastinothoracic or cervicomediastinothoracic "Rendevouz" drainage (MTC-D). In the group, we evaluated the source of infection, microbiologic findings, method of mediastinal drainage, length of hospitalisation, ventilation duration and inflammatory laboratory parameters. RESULTS: In total, we treated 22 patients with DNM, including 14 men and 8 women, aged 23 - 85 years, with a mean age of 54.1 years. After the spread of infection, in 8 cases the initial cervicomediastinal type of drainage had to be followed by one of the types of thoracic drainage. As the final method, in 8 patients we chose irrigation drainage from the cervical approach, from thoracotomy in 6 cases and in 8 cases irrigation CMT-D. The method of mediastinal drainage was chosen according to the initial CT findings, and further intervention was chosen according to CT signs during the treatment. Four patients died of DNM (mortality 18.2%). Pharyngeal focus was responsible for 15 cases of DNM; odontogenic infection caused 6 DNM cases; in 1 case the origin was unclear. Although we always chose the method individually and CMT-D for the most difficult cases, there were no statistically significant (p < 0.05) differences between the evaluated parameters. For CMT-D, there was even a shorter hospital stay (not significant) and ventilation duration. CONCLUSION: In cases of DNM with severe inflammation of caudal and distal compartments of the mediastinum we consider CMT-D as an ideal method of treatment. This appraoch is radical enough and in our group of patients, despite the severity of this illness, both the length of treatment and mortality were sufficient.


Assuntos
Mediastinite , Drenagem , Feminino , Humanos , Masculino , Mediastinite/diagnóstico , Mediastinite/cirurgia , Mediastino , Pessoa de Meia-Idade , Necrose , Estudos Retrospectivos
5.
Khirurgiia (Mosk) ; (2): 53-57, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33570355

RESUMO

OBJECTIVE: To assess the possibilities of omentoplasty for prevention of complications after redo sternum osteosynthesis for traumatic rupture. MATERIAL AND METHODS: The study included 53 patients with recurrent sternal diastasis. Greater omentum was additionally implanted in 19 (35.8%) cases to improve healing and reduce the risk of infectious complications. In 34 patients, redo osteosynthesis was carried out using a metal wire and deployment of irrigation-aspiration system. In 19 patients, omentoplasty was additionally used to close the wound. RESULTS: Omentoplasty was characterized by less duration of lavage (7.4±1.5 vs. 4.2±3.3 days, p<0.0001) and no cases of arrosive bleeding (p=0.04). CONCLUSION: Omentoplasty reduces duration of treatment and risk of arrosive bleeding.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Fixação Interna de Fraturas/métodos , Mediastinite/cirurgia , Omento , Esterno/cirurgia , Cicatrização , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Fixação Interna de Fraturas/efeitos adversos , Fixação Interna de Fraturas/instrumentação , Humanos , Mediastinite/etiologia , Mediastinite/prevenção & controle , Omento/cirurgia , Omento/transplante , Hemorragia Pós-Operatória/etiologia , Hemorragia Pós-Operatória/prevenção & controle , Recidiva , Irrigação Terapêutica
6.
Artigo em Inglês | MEDLINE | ID: mdl-33577144

RESUMO

Deep sternal wound infection is a major complication of cardiac surgery, with a low incidence but with catastrophic consequences in terms of morbidity, mortality, and health-care costs. Negative pressure wound therapy and appropriately timed sternal revision, with or without muscle flap mobilization, can improve the outcomes. This video tutorial illustrates the technical aspects of the surgical treatment of mediastinitis with the Robicsek method for sternal closure and an original wound closure technique, very effective and much simpler than the pectoral muscle flap technique.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Mediastinite/cirurgia , Infecção da Ferida Cirúrgica/cirurgia , Técnicas de Fechamento de Ferimentos , Idoso , Humanos , Masculino , Mediastinite/etiologia , Tratamento de Ferimentos com Pressão Negativa , Reoperação , Esternotomia/efeitos adversos , Esterno/cirurgia , Retalhos Cirúrgicos , Infecção da Ferida Cirúrgica/complicações , Resultado do Tratamento
7.
Cardiovasc Intervent Radiol ; 44(3): 384-391, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33205295

RESUMO

PURPOSE: Fibrosing mediastinitis is a rare disease characterized by fibrosis of mediastinal structures with subsequent constriction of the bronchi and pulmonary vessels leading to potential respiratory compromise and death. Presently, there is no effective curative treatment with available treatments focused on reducing symptomology, including placement of pulmonary artery stents. Limited studies examine the use of stents in fibrosing mediastinitis. Given this knowledge gap, we assessed stent patency, hemodynamics, complications, and secondary outcomes of clinical improvement of pulmonary artery stenting for fibrosing mediastinitis. MATERIALS AND METHODS: Nine patients with fibrosing mediastinitis and pulmonary artery stents were retrospectively identified for inclusion (six females, three males; mean age 44.17 years, range 13-68; total 13 primary stents) from 2005 to 2018. Eight patients had history of PH. All patients had dyspnea on presentation. Seven patients had ventilation/perfusion studies demonstrating impairment. Results from computed tomography and echocardiography studies were collected to assess patency and physiologic response. RESULTS: All patients received initial angioplasty and stenting of the right pulmonary artery (10 stents). Two patients underwent additional left-sided intervention (3 stents). Stenting significantly increased lesion luminal patency (54-79%; P < 0.005) and reduced systolic pressure gradients across stenoses (mean -9.38 mmHg; P < 0.005). Primary patency at one year was 90%. Two stents received reintervention at 276 and 497 days. 89% reported improvement in dyspnea in the initial post-stenting period. There were no mortalities or major complications. CONCLUSION: Pulmonary artery stenting improves vascular patency and provides symptomatic relief in patients with fibrosing mediastinitis.


Assuntos
Mediastinite/cirurgia , Artéria Pulmonar/cirurgia , Esclerose/cirurgia , Stents , Adolescente , Adulto , Idoso , Ecocardiografia , Feminino , Humanos , Masculino , Mediastinite/diagnóstico por imagem , Pessoa de Meia-Idade , Artéria Pulmonar/diagnóstico por imagem , Estudos Retrospectivos , Esclerose/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Grau de Desobstrução Vascular , Adulto Jovem
8.
Khirurgiia (Mosk) ; (12): 93-98, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33301261

RESUMO

Perforation of the esophagus is a serious and dangerous condition due to progressive development of mediastinitis and sepsis. This disease is often fatal. In the last decade, endoscopic stenting of the esophagus became more common in these patients as an alternative to traditional surgery. We report successful minimally invasive endoscopic treatment of esophageal perforation with post-burn necrosis of its wall.


Assuntos
Perfuração Esofágica , Esofagoscopia , Mediastinite , Implantação de Prótese/métodos , Drenagem , Perfuração Esofágica/diagnóstico , Perfuração Esofágica/etiologia , Perfuração Esofágica/cirurgia , Humanos , Mediastinite/diagnóstico , Mediastinite/etiologia , Mediastinite/cirurgia , Sepse/etiologia , Stents
9.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33370968

RESUMO

A 50-year-old Caucasian man presented to the emergency department during the early stages of the COVID-19 pandemic with a rapidly progressive facial swelling, fever, malaise and myalgia. The patient had recently travelled to a COVID-19-prevalent European country and was therefore treated as COVID-19 suspect. The day before, the patient sustained a burn to his left forearm after falling unconscious next to a radiator. A CT neck and thorax showed a parapharyngeal abscess, which was surgically drained, and the patient was discharged following an intensive care admission. He then developed mediastinitis 3 weeks post-discharge which required readmission and transfer to a cardiothoracic unit for surgical drainage. This report discusses the evolution of a deep neck space infection into a mediastinitis, a rare and life-threatening complication, despite early surgical drainage. This report also highlights the difficulties faced with managing patients during the COVID-19 pandemic.


Assuntos
COVID-19 , Drenagem , Mediastinite , Administração dos Cuidados ao Paciente/métodos , Complicações Pós-Operatórias , Abscesso Retrofaríngeo , Procedimentos Cirúrgicos Torácicos/métodos , COVID-19/tratamento farmacológico , COVID-19/epidemiologia , COVID-19/terapia , Doença Catastrófica/terapia , Diagnóstico Diferencial , Drenagem/efeitos adversos , Drenagem/métodos , Humanos , Controle de Infecções/métodos , Masculino , Mediastinite/diagnóstico , Mediastinite/etiologia , Mediastinite/fisiopatologia , Mediastinite/cirurgia , Pessoa de Meia-Idade , Pescoço/diagnóstico por imagem , Pescoço/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/cirurgia , Abscesso Retrofaríngeo/diagnóstico , Abscesso Retrofaríngeo/fisiopatologia , Abscesso Retrofaríngeo/cirurgia , SARS-CoV-2 , Resultado do Tratamento
10.
J Card Surg ; 35(11): 3191-3194, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32740995

RESUMO

Mycobacterium chimaera can cause disseminated infection following cardiac surgery with cardiopulmonary bypass and contaminated heater-cooler devices. We discuss a 41-year-old man with a disseminated M. chimaera infection following surgery for a type A aortic dissection. His presentation included cachexia and dorsalgia with a work-up revealing vertebral osteomyelitis with an epidural abscess, bone marrow, and pulmonary infiltration, and fluid collection around his aortic graft. He received 1 month of antibiotics before the explantation of infected foreign material, mediastinal debridement, and aortic reconstruction. Complications included septic shock, respiratory and renal failure, mediastinitis, and four distal aortic anastomotic dehiscences from friable tissue and persistent infection.


Assuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Mediastinite/etiologia , Mediastinite/cirurgia , Infecções por Mycobacterium/etiologia , Infecções por Mycobacterium/cirurgia , Mycobacterium , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Infecção da Ferida Cirúrgica/cirurgia , Adulto , Aneurisma Dissecante/cirurgia , Aorta/cirurgia , Aneurisma Aórtico/cirurgia , Implante de Prótese Vascular/métodos , Ponte Cardiopulmonar/efeitos adversos , Evolução Fatal , Humanos , Masculino , Mediastinite/microbiologia , Infecções por Mycobacterium/diagnóstico , Infecções por Mycobacterium/microbiologia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/microbiologia , Reoperação , Retalhos Cirúrgicos , Infecção da Ferida Cirúrgica/microbiologia
11.
Rozhl Chir ; 99(4): 189-193, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32545983

RESUMO

Descending necrotizing mediastinitis is a severe, fulminant, life-threatening bacterial infection of the mediastinum. Even though improvements in diagnostics and treatment were achieved, the mortality rate remain shigh. Contrast-enhanced CT of chest and neck is the diagnostic gold standard. Radical debridement and drainage of the mediastinum should be considered the primary therapeutic target. The authors present a complicated case of a female patient with cervical necrotizing fasciitis and descending necrotizing mediastinitis. She was initially treated for a deep neck infection at the department of otorhinolaryngology. Surgical treatment, antibiotics, and intensive care became an integral part of the therapy after the transfer to the department of thoracic surgery. The authors had to face various complications with tracheostomy and extensively debrided soft tissues in the neck region. That is why the patient underwent repeated surgeries during several hospital stays, with an overall duration of treatment reaching 220 days.


Assuntos
Fasciite Necrosante/cirurgia , Mediastinite/complicações , Mediastinite/diagnóstico por imagem , Mediastinite/cirurgia , Drenagem , Feminino , Humanos , Pescoço , Necrose , Traqueostomia
12.
Clin J Gastroenterol ; 13(5): 703-707, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32514685

RESUMO

Although endoscopic submucosal dissection has been increasingly performed for managing superficial esophageal carcinomas, the risk of post-operative esophageal stenosis remains. Endoscopic balloon dilation for esophageal stenosis is the most common cause of esophageal perforation. Esophageal perforation complicated with mediastinal abscess and sepsis has a high mortality rate. The standard treatment for esophageal perforation is closure. However, the late diagnosis of a case necessitates that treatment of mediastinitis be prioritized over closure of the perforation. We report the case of a 70-year-old man with post-endoscopic submucosal dissection stenosis who underwent endoscopic balloon dilation. Six days after the 16th endoscopic balloon dilation, the patient came to our hospital with a complaint of chest discomfort. Upon assessment, an esophageal perforation and a mediastinal abscess became evident. Because the patient's systemic condition remained stable, instead of performing surgery, we treated the patient conservatively by placing a nasomediastinal drain. After daily rinsing, the mediastinal abscess eventually regressed on the 15th hospital day. The esophageal perforation also closed spontaneously after removing the drainage tube. Nasomediastinal drainage placement appears to be effective in treating an esophageal perforation with a mediastinal abscess.


Assuntos
Perfuração Esofágica , Doenças do Mediastino , Mediastinite , Abscesso/complicações , Abscesso/cirurgia , Idoso , Drenagem , Perfuração Esofágica/etiologia , Perfuração Esofágica/cirurgia , Humanos , Masculino , Doenças do Mediastino/complicações , Doenças do Mediastino/cirurgia , Mediastinite/etiologia , Mediastinite/cirurgia
13.
Heart Lung Circ ; 29(10): 1561-1565, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32094079

RESUMO

BACKGROUND: Post-sternotomy mediastinitis (PSM) is a serious complication of median sternotomy. It is associated with a high mortality rate. Evidence based management recommends debridement followed by closure with vascularised flaps. When large areas of resections are performed, the use of sternal prosthesis could be considered to ensure chest wall stability and cosmesis. METHOD: We report an individualised three-dimensional (3D)-printed high-density polyethylene (HDPE) sternum implantation in a patient with a 10 cm chest wall defect. RESULTS: Chest wall reconstruction was uncomplicated and the patient tolerated the procedure well without cardiorespiratory compromise. Postoperatively, the wound healed well and the chest wall remained stable at outpatient clinic follow-up. CONCLUSION: Three-dimensional-printed HDPE prosthesis offers an alternative implant option for closing large chest wall defects for eroded sternum after cure of mediastinitis.


Assuntos
Ponte de Artéria Coronária/efeitos adversos , Mediastinite/cirurgia , Polietileno , Impressão Tridimensional , Caixa Torácica/cirurgia , Esternotomia/efeitos adversos , Infecção da Ferida Cirúrgica/cirurgia , Humanos , Masculino , Mediastinite/etiologia , Pessoa de Meia-Idade , Desenho de Prótese , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/etiologia , Tomografia Computadorizada por Raios X
16.
In. Machado Rodríguez, Fernando; Liñares, Norberto; Gorrasi, José; Terra Collares, Eduardo Daniel. Manejo del paciente en la emergencia: patología y cirugía de urgencia para emergencistas. Montevideo, Cuadrado, 2020. p.213-222, ilus, tab.
Monografia em Espanhol | LILACS, BNUY, UY-BNMED | ID: biblio-1343005
17.
Khirurgiia (Mosk) ; (11): 13-19, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31714524

RESUMO

OBJECTIVE: To analyze the results of chest wall reconstruction with titanium mesh implant in patients with total sternal instability following postoperative sternomediastinitis. MATERIAL AND METHODS: There were 100 patients with total sternal instability for the period from January 2016 to December 2018. Median of age was 62 (58; 68) years. Male/female ratio was 82/18. All patients were treated in accordance with standardized protocol. Postoperative complications were assessed using Clavien-Dindo scale. Staged surgical treatment including one or more debridement procedures before the final thoracoplasty was performed in 62 (62%) out of 100 patients. Aseptic sternal instability was observed in 38 patients. RESULTS: Follow-up period ranged from 3 weeks to 35 months after the final thoracoplasty. Complicated postoperative period occurred in 15 (15%) out of 100 patients (95% CI 9.3-23.3). One patient died in 9 days after surgery from acute heart failure. Complications without need for redo surgery, postoperative wound suppuration and seroma were noted in 3 patients. Redo surgery was required in 11 patients due to postoperative wound suppuration, eventration after thoracoomentoplasty, intermuscular hematoma and delayed divergence of major pectoral muscles. Removal of mesh implant was performed in 1 out of 100 patient (95% CI 0.2-5.5) in 7 days after surgery due to suppuration. There was no recurrent sternal instability within 30 days. CONCLUSION: Anterior chest wall reconstruction using titanium mesh implant is an effective and safe procedure in patients with postoperative sternal instability following postoperative sternomediastinitis.


Assuntos
Mediastinite/cirurgia , Osteomielite/cirurgia , Complicações Pós-Operatórias/cirurgia , Esterno/cirurgia , Infecção da Ferida Cirúrgica/cirurgia , Toracoplastia/métodos , Idoso , Feminino , Seguimentos , Humanos , Masculino , Mediastinite/etiologia , Pessoa de Meia-Idade , Osteomielite/etiologia , Implantação de Prótese , Recidiva , Estudos Retrospectivos , Telas Cirúrgicas , Titânio
19.
J Reconstr Microsurg ; 35(9): 705-712, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31362322

RESUMO

BACKGROUND: Bilateral PM muscles or combination with rectus abdominis or omentum are commonly used for upper and lower sternal wound infections. Unilateral PM harvesting using endoscopic-assisted method may have a simple, safe, and reliable entire muscle harvesting with comparable result of less donor-site violation. METHODS: A retrospective review was performed from 2003 till 2015 on 38 patients referred to a single plastic surgeon for treatment of sternal wound infection following median sternotomy for cardiovascular surgery. After the humerus insertion of PM was cut with the assistance of endoscope visualization, all the other PM insertions on the sternum, rib, and clavicle were divided, the unilateral pedicled PM can be advanced approximately 10 cm to cover the cephalad and caudal sternum, and fill the retrosternal mediastinum. RESULTS: Four re-explorations in three patients for postoperative hematoma occurred. No early recurrent infection for wound dehiscence experienced. Three patients died of multiple organs failures as 30-day mortality. Two patients underwent late recurrent infections; one patient had twice wire infection removals at 4 and 6 months after transfer, and the other had another PM for rib osteomyelitis in 3 years. CONCLUSION: Unilateral PM transfer is justified to provide a simple, reliable, straightforward procedure for sternal infection management and mediastinal obliteration without violation of second flap in compromised patients.


Assuntos
Endoscopia , Mediastinite/cirurgia , Músculos Peitorais/transplante , Esterno/cirurgia , Retalhos Cirúrgicos/transplante , Infecção da Ferida Cirúrgica/cirurgia , Adulto , Idoso , Procedimentos Cirúrgicos Cardíacos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Esternotomia
20.
Eur Arch Otorhinolaryngol ; 276(7): 2075-2079, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31093735

RESUMO

PURPOSE: Descending cervical mediastinitis (DCM) is defined as spread of oropharyngeal or odontogenic infection into the mediastinum. It occurs uncommonly and has a high mortality rate. METHODS: Six patients underwent surgery at our centre for DCM between November 2013 and October 2016. Five of six patients underwent drainage of neck collections via a cervical approach, and all six patients subsequently underwent thoracic surgery for drainage of pleural and mediastinal collections. RESULTS: Four patients required further surgical intervention, of which two subsequently required a third thoracic operation. The average length of stay was 73 days (range 4-193). There were no in-hospital deaths and all patients were discharged from our hospital. CONCLUSIONS: Following diagnosis, prompt surgical intervention from ENT and cardiothoracic surgeons is essential. Our experience demonstrates that favourable outcomes can be achieved in patients with DCM when they are managed aggressively and promptly in specialist centres with appropriate multidisciplinary team involvement.


Assuntos
Mediastinite , Otorrinolaringopatias/complicações , Cirurgia Torácica Vídeoassistida/métodos , Adulto , Idoso , Drenagem/métodos , Feminino , Humanos , Masculino , Mediastinite/diagnóstico , Mediastinite/etiologia , Mediastinite/cirurgia , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Resultado do Tratamento , Reino Unido
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