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Prosthesis for open pleurostomy (POP): management for chronic empyemas
Filomeno, Luiz Tarcísio Brito; Campos, José Ribas Milanez de; Machuca, Tiago Noguchi; Neves-Pereira, João Carlos das; Terra, Ricardo Mingarini.
Afiliação
  • Filomeno, Luiz Tarcísio Brito; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Department of Thoracic Surgery. São Paulo. BR
  • Campos, José Ribas Milanez de; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Department of Thoracic Surgery. São Paulo. BR
  • Machuca, Tiago Noguchi; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Department of Thoracic Surgery. São Paulo. BR
  • Neves-Pereira, João Carlos das; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Department of Thoracic Surgery. São Paulo. BR
  • Terra, Ricardo Mingarini; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Department of Thoracic Surgery. São Paulo. BR
Clinics ; Clinics;64(3): 203-208, 2009. ilus
Article em En | LILACS | ID: lil-509425
Biblioteca responsável: BR1.1
ABSTRACT

OBJECTIVES:

We developed a prosthesis for open pleurostomy cases where pulmonary decortication is not indicated, or where post-pneumonectomy space infection occurs. The open pleural window procedure not only creates a large hole in the chest wall that is shocking to patients, also results in a permanent deformation of the thorax. prosthesis for open pleurostomy is a self-retained silicone tube that requires the removal of 3 cm of one rib for insertion, and acts as a mature conventional open pleural window. Herein, we report our 13-year experience with this device in the management of different kinds of pleural empyema.

METHODS:

Forty-four consecutive patients with chronic empyema were treated. The etiology of empyema was diverse pneumonia, 20; lung resections, 12 (pneumonectomies, 7; lobectomies, 4; non-anatomical, 1); mixed-tuberculous, 6; and mixed-malignant pleural effusion, 6. After debridment of both pleural surfaces, the prosthesis for open pleurostomy was inserted and attached to a small recipient plastic bag.

RESULTS:

Infection control was achieved in 20/20 (100 percent) of the parapneumonic empyemas, in 3/4 (75 percent) of post-lobectomies, in 6/7 (85 percent) of post-pneumectomies, in 6/6 (100 percent) of mixed-tuberculous cases, and in 4/6 (83 percent) of mixed-malignant cases. Lung re-expansion was also successful in 93 percent, 75 percent, 33 percent, and 40 percent of the groups, respectively

CONCLUSIONS:

Prosthesis for open pleurostomy insertion is a minimally invasive procedure that can be as effective as conventional open pleural window for management of chronic empyemas. Thus, we propose that the use of prosthesis for open pleurostomy should replace the conventional method.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Toracostomia / Drenagem / Empiema Pleural Limite: Adolescent / Adult / Aged / Female / Humans / Male Idioma: En Revista: Clinics Assunto da revista: MEDICINA Ano de publicação: 2009 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Toracostomia / Drenagem / Empiema Pleural Limite: Adolescent / Adult / Aged / Female / Humans / Male Idioma: En Revista: Clinics Assunto da revista: MEDICINA Ano de publicação: 2009 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil