ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
THE IMPORTANCE OF THORACOMYOPLASTY IN CHRONIC EMPYEMA
Yekta Altemur Karamustafaoğlu, *Levent Cansever, *Ayşe Gül Çevik, *Gökhan Hacıibrahimoğlu, *Cemal Asım Kutlu, *Mehmet Ali Bedirhan
Yüksek İhtisas Hastanesi, 3. Göğüs Cerrahisi Kliniği, Kırıkkale
*Yedikule Göğüs Hastalıkları Hastanesi, Göğüs Cerrahisi Kliniği, İstanbul
Background: Between 1994-2002, we investigated retrospectively the results of 15 cases received thoracomyoplasty.

Methods: In our clinic, we evaluated 15 thoracomyoplasty cases which mean age was 50.7 years (25-76), and 13 of them were male and the remaining 2 were female. The empyema was seen in 9 patients at right and in 6 patients at left hemithorax. The empyema was diagnosed in 4 patients clinically and in the other patients with thorax computarized tomography and thoracentesis. After the stabilisation of the patients situation, we performed open drainage (thoracostoma) at 11 patients. We made the decision of the operation due to the cleaning of thoracostoma, the occurence of granulation and the general physical condition of the patient.

Results: The etiology was postpneumonectomy empyema in 7 patients, postinfection empyema in 7 patients and postlobectomy empyema in 1 patient. The most common (60%) microbiological agent was determined as Pseudomonas aeroginosa. We performed thoracomyoplasty to 5 patients, myoplasty to 8 of them and thoracoplasty in the remaining 2 patients. We prepared the patients for the cavity sterilisation between 1-11 months. We made repair of bronchial fistula before thoracomyoplasty to the cases of bronchopleural fistulas. There were no mortality and morbidity except the seroma and wound infection.

Conclusions: We decided that the thoracomyoplasty is an effective procedure for the chronic empyema.

Keywords : Empyema, thoracomyoplasty, infection, thoracic surgery
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