title: Closure of fenestra in Clagett procedure: use of rectus abdominis musculocutaneous flap.
abstract: Empyema developed in a 62-year-old man after right pneumonectomy for lung cancer. According to the Clagett procedure, an open window thoracostomy was made with two ribs removed. After 5 weeks, primary closure of the fenestra was attempted. Because the fenestra was too large to be primarily closed, a rectus abdominis musculocutaneous flap was successfully transposed to cover the chest wall. There was no evidence of recurrence of empyema during 11 months' observation after closure. In patients with a large fenestra and with little tissue left for closure, the rectus abdominis musculocutaneous flap could be of great help in completing the Clagett procedure.
authors.affiliation: Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Asamura
authors.forename: T
authors.initials: T
authors.lastname: Goya
authors.forename: T
authors.initials: T
authors.lastname: Naruke
authors.forename: R
authors.initials: R
authors.lastname: Tsuchiya
authors.forename: H
authors.initials: H
authors.lastname: Kondo
authors.forename: K
authors.initials: K
authors.lastname: Suemasu
authors.forename: T
authors.initials: T
authors.lastname: Nakatsuka
mesh_terms: D000009:Abdominal Muscles; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D016724:Empyema, Pleural / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D012008:Recurrence; D013524:Surgical Flaps / Q000379:methods*; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000601:surgery*