[A case of postpneumonectomy empyema cured by open drainage thoracotomy and thoracoplasty with pectoral myoplasty].
The patient was a 57-year-old male with lung adenocarcinoma arising in right upper lobe. Because the tumor invaded to the trunchus intermedius and B6, right upper lobe, middle lobe and S6 was resected with bronchial plasty which was performed between the main bronchus and basal bronchus. Because the bronchial fistula appeared after 12 days of operation, completion pneumonectomy was performed, and the stump of the main bronchus was covered with intercostal muscle. Although fistula of the bronchial stump did not appear, open drainage thoracotomy was performed because of deterioration of empyema due to methicillin resistant staphylococcus aureus (MRSA). After 10 weeks of open drainage, although MRSA did not disappear, the thoracoplasty with interthoracic transposition of the major and minor pectoral muscles was performed. Empyema was cured, and the patient left the hospital 2 weeks after thoracoplasty. Thoracoplasty with pectoral myoplasty was useful for single-staged closure of post-pneumonectomy empyema.
Nomori
H
H
Department of Surgery, Saiseikai Central Hospital.
Kobayashi
R
R
Kaneko
T
T
D004322:Drainage; D016724:Empyema, Pleural / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010369:Pectoralis Muscles / Q000637:transplantation*; D011013:Pneumonectomy / Q000009:adverse effects*; D013524:Surgical Flaps; D013905:Thoracoplasty; D013908:Thoracotomy