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Clagett open-window thoracostomy in patients with empyema who had and had not undergone pneumonectomy.
Bayes, A J; Wilson, J A; Chiu, R C; Errett, L E; Hedderich, G; Munro, D D.
Afiliação
  • Bayes AJ; Department of Surgery, Montreal Chest Hospital Center, PQ.
Can J Surg ; 30(5): 329-31, 1987 Sep.
Article em En | MEDLINE | ID: mdl-3664384
Patients with empyema not responding to simple chest-tube drainage and antibiotic therapy have been managed by a "Clagett"-type procedure that consists of open-window thoracostomy, antibiotic irrigation and closure of the window. The results of such treatment were reviewed. Of the 103 patients with empyema treated between 1967 and 1983, 41 underwent open-window thoracostomy. Twenty-eight (group 1) had empyema after pneumonectomy, 13 (group 2) did not; however, 9 of the 13 in group 2 had undergone lobectomy. The mean follow-up was 46 months for group 1 and 42 months for group 2. When surgical closure of the open-window thoracostomy was attempted, the success rate in group 1 was 85% for those without concomitant bronchopleural fistula, but only 36% in patients with a fistula. In group 2 the respective success rates were 50% and 57%. Unsuccessful closure resulted in chronic fistulas in four patients in each of the two groups. Six deaths in group 1 and two in group 2 were related to the original disease, but one was an operative death. These results demonstrate both the effectiveness and limitations of open-window thoracostomy in the management of these difficult cases.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonectomia / Toracostomia / Empiema Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Can J Surg Ano de publicação: 1987 Tipo de documento: Article País de publicação: Canadá
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonectomia / Toracostomia / Empiema Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Can J Surg Ano de publicação: 1987 Tipo de documento: Article País de publicação: Canadá