Imura Y, Ohtsuka T, Yamamoto H, Kobayashi T, Suzuki A, Nakano H, Imahashi M
Kekkaku. 1989 Sep;64(9):545-9.
In 13 patients undergone reoperation for chronic empyema during 9 years period from 1975 to 1983, the operative technique employed for the initial treatment, number of operations, findings of fistula and residual cavity and complications associated with each technique were reviewed with following results. Among these reoperated patients, the initial operation was thoracic cavity reduction in 5 cases, pulmonary detachment in 6 cases and air-plombage (Kinchu method) in 2 cases. Reoperation was carried out in a total of 27 times. There were 6 cases (46%) which were operated more than 3 times. These 6 cases included none of the cases which underwent air plombage. At the time of the first reoperation, fistula was observed in 11 out of 13 cases. At the final operation the residual cavity was accompanied with fistula in 7 cases and empyema in 5 cases. As the final operation, chest wall plombage chiefly by a modification of Grow's method combined with pedicle muscle plombage was employed. In cases indicated for more than two times of operations of thoracic cavity reduction, chest wall plombage was useful for reoperation. On the basis of these results, indication of each operation to improve results of surgical treatment of chronic empyema was discussed by taking into consideration advantages and complications of each operative technique.
在1975年至1983年的9年期间，对13例因慢性脓胸接受再次手术的患者进行了回顾，分析了初次治疗所采用的手术技术、手术次数、瘘管和残余腔的情况以及每种技术相关的并发症，结果如下。在这些再次手术的患者中，初次手术为胸廓成形术的有5例，肺叶切除术的有6例，气腔填充术（金竹法）的有2例。总共进行了27次再次手术。有6例（46%）接受了3次以上的手术。这6例中没有接受气腔填充术的病例。首次再次手术时，13例中有11例观察到瘘管。最后一次手术时，残余腔伴有瘘管的有7例，伴有脓胸的有5例。作为最后一次手术，主要采用改良的格罗夫法结合带蒂肌填充术进行胸壁填充术。对于需要进行两次以上胸廓成形术的病例，胸壁填充术对再次手术有用。基于这些结果，通过考虑每种手术技术的优点和并发症，讨论了每种手术对改善慢性脓胸外科治疗效果的适应证。
