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- Title
Intrathoracic negative pressure therapy and/or endobronchial valve for pleural empyema minimal invasive management: case series of thirteen patients and review of the literature.
- Authors
Panko, Siarhei; Vakulich, Denis; Karpitski, Aliaksandr; Zhurbenka, Henadzi; Shestiuk, Andrej; Boufalik, Rostislav; Ihnatsiuk, Aliaksandr
- Abstract
Introduction: Intrathoracic negative pressure therapy is an adjunct to standard methods of complex empyema management in debilitated patients. Nevertheless, the use of endoscopic one-way endobronchial valves to successfully close large bronchopleural fistulas in patients with advanced pleural empyema has been described in only a few case reports. Aim: To present our experience in managing complex pleural empyema using thoracostomy with intrathoracic negative pressure therapy and/or endobronchial valve implantation. Material and methods: We retrospectively analyzed data from 13 consecutive patients (11 men, mean age: 56 years, range: 38-80 years) who were treated for pleural empyema using thoracostomy with intrathoracic negative pressure therapy and/or endobronchial valve implantation between October 2015 and November 2017. Results: The control of empyema was satisfactory in 12 patients; however, 1 patient died from sepsis-related multiorgan failure despite complete cessation of air leak on day 9 after endobronchial valve implantation. The overall success rate for the final closure of the chest wall was 9/12 patients (75%): in 5 patients, the wall closed spontaneously, and in 4, the wall was closed using thoracomyoplasty. Conclusions: Thoracostomy with intrathoracic negative pressure therapy, endobronchial valve implantation with tube drainage, and a combination of the two could adequately manage patients with pleural empyema with or without a persistent air leakage fistula.
- Subjects
BRONCHIAL fistula; EMPYEMA; LITERATURE reviews; VALVES; MULTIPLE organ failure; CHECK valves; PRESSURE
- Publication
Videosurgery & Other Miniinvasive Techniques / Wideochirurgia i Inne Techniki Mało Inwazyjne, 2020, Vol 15, Issue 4, p588
- ISSN
1895-4588
- Publication type
Article
- DOI
10.5114/wiitm.2020.93210