Autologous myocutaneous flap implantation for chronic refractory empyema: 26 cases report

Abstract

Objective To summarize experience in the treatment of chronic refractory empyema with autologous myocutaneous flap implantation. Methods From January 2004 to December 2017, 26 patients had been treated with autologous myocutaneous flap implantation in Shanghai Pulmonary Hospital for chronic refractory empyema. Among them, 24 were men and 2 were women. The mediam age was 50.1 years(14-74 years). 21 of them had medical histories of lung resection because of basic diseases(most of which accepted surgeries in other hospitals). Complications appeared after surgeries. 15 of them had bronchopleural fistula while windowing, which could not be cured by conservative treatments such as drainage. Then we performed open-window thoracostomy and long-time dressing. 6 of 21 had experienced pneumonectomy. Other 5 patients did not have primary operational histories. They experienced dressing by windowing because of chronic refractory empyema after the ineffective conservative treatments like drainage without pulmonary re-expansion. Results No respiratory complications occurred in these patients. The catheters were successfully removed within 5 days and the patients were discharged within 3-6 weeks after the operations. The median follow-up period was 9 months. 24 cases were successful with no recurrence of empyema or flap necrosis, the other 2 cases underwent recurrence of empyema. Conclusion The application of autologous myocutaneous flaps for the treatment of chronic refractory empyema is an effective and continuously improving method. Key words: Chronic refractory pleural empyema Autologous myocutaneous flap Open-window thoracostomy