Efficacy evaluation of autologous muscle flap transposition or myocutaneous flap transplantation for postoperative chronic empyema with bronchopleural fistula.

BACKGROUND

Chronic empyema with bronchopleural fistula (BPF) after pulmonary resection is difficult to treat. The aim of the study is to explore the efficacy of autologous muscle flap or myocutaneous flap on chronic empyema with BPF.

METHODS

Retrospective analysis of 10 patients with postoperative chronic empyema with BPF treated in our hospital, including 8 males and 2 females, with ages ranging from 20 to 83 years, yielding an average age of (51.00 ± 19.22) years. The treatment of all patients with chronic empyema follows a staged surgical model. The first stage of surgery involves debridement, partial rib resection, and fistula closure, while the second stage includes autologous muscle flap transposition or free myocutaneous flap transplantation to eliminate the abscess cavity. The primary objectives of the first-stage surgery include ensuring adequate drainage, controlling infection, and achieving fistula closure. In contrast, the key focus of the second-stage surgery is the complete filling of the abscess cavity with a sufficient volume of autologous tissue flap.

RESULTS

There were no perioperative deaths. The average follow-up was (19.88 ± 9.03) months. None of the 10 patients had recurrence of empyema and BPF. All autologous muscle flaps or myocutaneous flaps survived. Postoperative chest computed tomography (CT) or magnetic resonance imaging (MRI) showed that the abscess cavity disappeared.

CONCLUSIONS

The application of autologous muscle flap or myocutaneous flap represents an effective approach for the treatment of chronic empyema with BPF, demonstrating satisfactory clinical outcomes in the short to medium term.