Miller J I, Mansour K A, Nahai F, Jurkiewicz M J, Hatcher C R
Ann Thorac Surg. 1984 Sep;38(3):227-31. doi: 10.1016/s0003-4975(10)62243-6.
The management of postpneumonectomy empyema remains a disturbing and controversial area in the field of thoracic surgery. Many methods have been described and have had varying degrees of success. We present a series of 5 consecutive patients who underwent single-stage complete muscle flap closure of the pneumonectomy space with extrathoracic muscle flaps and omental grafts between October, 1981, and April, 1983. Two men and three women ranging from 37 years to 64 years old underwent such a closure from 3 to 13 months after original resection. Two patients had associated bronchopleural fistula. Prior to closure, 3 patients were managed with chest tubes and 2 with a modified Eloesser procedure. All operations were single-stage procedures, and all wounds closed primarily, with no permanent tubes or chest wall openings. There was no morbidity or mortality, and no subsequent operation has been required. Single-stage complete muscle flap closure of the postpneumonectomy empyema space has not been described previously, and we think it offers a possible solution to this potentially fatal complication.
肺切除术后脓胸的处理在胸外科领域仍然是一个令人困扰且存在争议的问题。已经描述了许多方法，且取得了不同程度的成功。我们报告了1981年10月至1983年4月期间连续5例患者，他们接受了用胸外肌瓣和网膜移植对肺切除腔进行一期完全肌瓣闭合术。2名男性和3名女性，年龄在37岁至64岁之间，在初次切除后3至13个月接受了这种闭合术。2例患者伴有支气管胸膜瘘。在闭合之前，3例患者采用胸管处理，2例采用改良的埃洛塞尔手术。所有手术均为一期手术，所有伤口均一期愈合，无永久性引流管或胸壁开口。无并发症或死亡病例，且无需后续手术。此前未曾描述过对肺切除术后脓胸腔进行一期完全肌瓣闭合术，我们认为它为这种潜在致命并发症提供了一种可能的解决方案。
