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带蒂背阔肌肌皮瓣胸内移位治疗复杂性慢性脓胸:在我们次区域推广的呼吁。

Intrathoracic Transposition of a Pedicled Latissimus Dorsi Muscle Flap for Complicated Chronic Empyema Thoracis: A Plea for its Popularity in our Subregion.

机构信息

Cardiothoracic Surgery Division, Federal Medical Centre, Abuja. E-mail:

Cardiothoracic Surgery Unit, Garki Hospital, Abuja.

出版信息

West Afr J Med. 2024 Jan 31;41(1):82-86.

Abstract

INTRODUCTION

Empyema thoracis is a debilitating disease that still constitutes a significant burden among thoracic surgical diseases in our environment. It sometimes occurs secondary to ruptured lung abscess with varying degrees of lung destruction and bronchopleural fistula.

CASE REPORT

A 65-year-old woman presented to our unit with a two-month history of cough which subsequently became productive of purulent sputum and posture-dependent, and fever, with progressive dyspnea on exertion. She was subsequently managed for chronic right empyema thoracis secondary to a ruptured lung abscess. We briefly describe the evaluation, indication, and technique for intrathoracic transposition of a pedicled latissimus dorsi muscle flap for operative management of this index disease, and the very good medium and long-term outcomes observed for this patient.

CONCLUSION

Where indicated and with meticulous preoperative planning, transposition of a pedicled latissimus dorsi muscle flap for complicated chronic empyema thoracis can prevent a surgical albatross with a reduced hospital stay, cost of treatment and excellent patient satisfaction at the meagre expense of about 30 minutes or less extra intra-operative time.

摘要

引言

脓胸是一种使人虚弱的疾病,在我们的环境中仍然是胸外科疾病的一个重要负担。它有时继发于肺脓肿破裂,伴有不同程度的肺破坏和支气管胸膜瘘。

病例报告

一名 65 岁女性因咳嗽两个月就诊,随后咳嗽产生脓性痰,体位依赖性,发热,逐渐出现劳力性呼吸困难。随后,她被诊断为慢性右侧脓胸,继发于肺脓肿破裂。我们简要描述了经胸内带蒂背阔肌肌皮瓣转移术的评估、适应证和技术,用于治疗这种疾病,以及为该患者观察到的非常好的中短期结果。

结论

在有指征的情况下,通过精心的术前规划,带蒂背阔肌肌皮瓣转移术治疗复杂的慢性脓胸,可以避免手术的困扰,减少住院时间、治疗费用和患者满意度,而只需要额外增加约 30 分钟或更少的手术时间。

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