title: Long-term complications of extraperiosteal plombage.
abstract: BACKGROUND
  As soon as complications due to migration of extraperiosteal plombage material had been documented, early removal became the rule. Some patients who have escaped this rule may still present with long-term complications.
  
  
  METHODS
  Since 1980, 14 patients aged 54 +/- 10 years were admitted 28 +/- 11 years after collapse therapy. Eight presented with signs of infection, 4 with hemoptysis, and 2 with periscapular pain. Vascular erosion, suspected in 3 patients, was demonstrated with angiograms in 1.
  
  
  RESULTS
  Ablation of the material was combined with excision of the devitalized ribs in 13 patients. Femorofemoral bypass was used in 2 patients for repair of an aortic erosion. Single ablation of subcutaneously migrated material was performed in a poor-risk patient. Operative bleeding was moderate except in 2 patients; 1 of them died intraoperatively during repair of an aortic erosion. A second patient died postoperatively with a massive pulmonary embolus on day 11. Infection was diagnosed in 8 patients (Mycobacterium tuberculosis, 4; and pyogens, 4). Operative outcome was satisfactory in all 12 operative survivors. A single patient presented with an infected apical space at 1 year and underwent complementary resection of the first rib.
  
  
  CONCLUSIONS
  We recommend routine ablation of any residual plombage material whenever operative risk is acceptable because of the high incidence of spontaneous complications.
authors.affiliation: Department of Thoracic Surgery, University Hospital of Strasbourg, France.
authors.forename: G
authors.initials: G
authors.lastname: Massard
authors.forename: P
authors.initials: P
authors.lastname: Thomas
authors.forename: P
authors.initials: P
authors.lastname: Barsotti
authors.forename: P
authors.initials: P
authors.lastname: Riera
authors.forename: R
authors.initials: R
authors.lastname: Giudicelli
authors.forename: E
authors.initials: E
authors.lastname: Reboud
authors.forename: G
authors.initials: G
authors.lastname: Morand
authors.forename: P A
authors.initials: PA
authors.lastname: Fuentes
authors.forename: J M
authors.initials: JM
authors.lastname: Wihlm
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications / Q000209:etiology*; D006801:Humans; D008297:Male; D008768:Methylmethacrylates; D008875:Middle Aged; D011025:Pneumonolysis / Q000009:adverse effects*; D019736:Prostheses and Implants / Q000009:adverse effects*; D013997:Time Factors
chemical_list: D008768:Methylmethacrylates