Yuste M G, Ramos G, Duque J L, Gonzalez Selma M L, Castanedo M
Service de Chirurgie Thoracique, Hôpital Universitaire, Valladolid, Espagne.
Ann Chir. 1991;45(8):711-4.
Between 1979 and 1986, 30 patients with chronic pleural empyema (19 with pyothorax secondary to tuberculosis and 11 with pleural empyema following pulmonary resection) underwent two-stage treatment. The first stage consisted of open thoracostomy and was followed, 2 to 7 months later, by thoracopleuromyoplasty with latissimus dorsi, serratus anterior and pectoralis major muscles either alone or in combination. There was no operative mortality in this series of 30 operated patients. Definitive obliteraion of the pleural cavity and closure of the bronchial fistulae were obtained in 26 of the 30 patients. Partial necrosis of the muscle graft in the other 4 patients required further open drainage and an additional myoplasty. The long-term functional results in the cases of post-resection empyema were compatible with the restriction created by the pulmonary resection and, in the cases of empyema with a residual lung, with the restriction of the volume and perfusion of pulmonary parenchyma.
1979年至1986年间，30例慢性脓胸患者（19例为结核继发脓胸，11例为肺切除术后脓胸）接受了两阶段治疗。第一阶段为开胸造口术，2至7个月后进行背阔肌、前锯肌和胸大肌单独或联合的胸廓成形术。这30例接受手术的患者中无手术死亡病例。30例患者中有26例实现了胸膜腔的彻底闭塞和支气管瘘的闭合。其他4例患者的肌瓣部分坏死，需要进一步开放引流和再次进行肌成形术。切除术后脓胸病例的长期功能结果与肺切除造成的功能受限相符，而在有残余肺的脓胸病例中，则与肺实质体积和灌注的受限相符。
