Surgery today · 2004
A novel approach to life-threatening cardiorespiratory distress from mediastinum exclusion type chronic empyema.
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Shigemura Norihisa, Akashi Akinori, Nakagiri Tomoyuki
Аннотация
PURPOSE: Mediastinal exclusion type of empyema (MEE) is known as a type of chronic matrical empyema with no retention of pus. However, the number of patients with this condition who undergo treatment is still very limited because the indications for a panpleuropneumonectomy, namely the main surgical treatment for MEE, are extremely rare due to their unfavorable conditions. As a result, most cases of this disease are left untreated.
METHODS: From April 2000 to December 2002, we experienced four cases of MEE, in which the conditions were so aggravated that cardiorespiratory insufficiencies were involved with them. All of them had been receiving oxygen therapy at home and the severity of symptoms were rated as III or IV according to the Hugh-Jones classification. The patients required surgical treatment as a semiemergency.
RESULTS: We successfully performed safe and effective treatment in all cases through a novel approach with a devised incision and the severance of the osseous thorax for a panpleuropneumonectomy.
CONCLUSION: We hope our newly devised operative method discussed herein will improve the outcome and postoperative management of chronic MEE patients.
METHODS: From April 2000 to December 2002, we experienced four cases of MEE, in which the conditions were so aggravated that cardiorespiratory insufficiencies were involved with them. All of them had been receiving oxygen therapy at home and the severity of symptoms were rated as III or IV according to the Hugh-Jones classification. The patients required surgical treatment as a semiemergency.
RESULTS: We successfully performed safe and effective treatment in all cases through a novel approach with a devised incision and the severance of the osseous thorax for a panpleuropneumonectomy.
CONCLUSION: We hope our newly devised operative method discussed herein will improve the outcome and postoperative management of chronic MEE patients.