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Thoracoplasty in the Management of Chronic Empyema: Experience of a Sub Saharan African Country

Received: 3 August 2017    Accepted: 11 August 2017    Published: 6 December 2017
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Abstract

Introduction: The current main indication of thoracoplasty is empyema following or not lung resection, when the other surgical methods such as thoracic drainage, pleurostomy and/or pulmonary decortication have failed or are not useful. The authors report the role of thoracoplasty in the management of chronic empyema. Method: Between 2004 and 2015, eight male patients underwent thoracoplasty, in the Department of Thoracic Surgery at the University Hospital of Fann, Dakar, Senegal. The mean age was 40 years old. In all cases, the first step of the treatment was thoracic drainage with Heimlich valve in an ambulatory patient, associated with antibiotic according to the result of bacterial culture. In three patients, thoracostomy was indicated to control local infection before thoracoplasty. Results: Indications for thoracoplasty were refractory post resectionnal lung empyema in 6 cases and chronic primary apical empyema in 2 cases. Bronchopleural fistula was found in 5 patients. We performed three superior partial thoracoplasty, and five enlarged thoracoplasty. A myoplasty, using latissimus dorsi to fill the empyema space, was associated with thoracoplasty in five cases. Bronchopleural fistula cure consisted of a direct X form suture in two cases and of intercostal muscle apposition on the fistula in others ones. Partial scapulectomy, by resection of the inferior third part of the scapula was done in three patients. After a mean follow up of one year, no patient presented with persistence or recurrence of empyema. Then we concluded that they were healed. Conclusion: Thoracoplasty is an efficient procedure for the management of chronic empyema. So it is necessary for each team to established define criteria that will allow a patient to undergo thoracoplasty in order to do not use it for any desperate case of refractory chronic empyema.

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 3, Issue 6)
DOI 10.11648/j.ijcts.20170306.12
Page(s) 70-74
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Thoracoplasty, Bronchopleural Fistula, Empyema, Tuberculosis

References
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[3] Botianu AM, Botianu PV. Role of thoracomyoplasty procedures in modern surgery for intrathoracic suppurations. In: Cardosso P. F. G. Topics in Thoracic Surgery. In Tech Ed., Rijeka, Croatia; 2012. p. 309–26
[4] R. K. Dewan, Sanjay Singh, Ashwini Kumar1, and Bhupender K. Meena. Thoracoplasty: An Obsolete Procedure? Indian J Chest Dis Allied Set 1999; 41: 83-8.
[5] Krassas A, Grima R, Bagan P, Badia A, Arame A, Le Pimpec Barthes F, Riquet M. Current indications and results for thoracoplasty and intrathoracic muscle transposition. Eur J Cardiothorac Surg 2010; 37: 1215—20
[6] Peppas G, Molnar TF, Jeyasingham K, Kirk AB. Thoracoplasty in the context of current surgical practice. Ann Thorac Surg 1993; 56:903–9.
[7] Stefani A, Jouni R, Alifano M, Bobbio A, Strano S, Magdeleinat P and Regnard JF. Thoracoplasty in the Current Practice of Thoracic Surgery: A Single-Institution 10-Year Experience. Ann Thorac Surg 2011; 91:263-8.
[8] Icard P, Le Rochais JP, Rabut B, Cazaban S, Martel B, Evrard C. Andrews thoracoplasty as a treatment of postpneumonectomy empyema: experience in 23 cases. Ann Thorac Surg 1999; 68: 1159 –64.
[9] Melki J, Lachkar S, Peillon C, Testart J, Muir JF, Thiberville L. Thoracoplastie Osteoplastique de BJÖRK. Indications et résultats. A propos d’une série de 29 patients. Chirurgie Thoracique Cardio-Vasculaire - 2008; 12: 88-94
[10] Pairolero P. C., Trastek MD, Trastek Victor F. Surgical Management of Chronic Empyema: The Role of Thoracoplasty. Ann Thorac Surg 1990; 50: 689-90
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[15] Pairolero PC; Arnold PG; Trastek VF, Meland BN, Kay PP. Post pneumonectomy empyema: role of intratoracic muscle transposition. J. Thorac Cardiovasc. Surg. 1990; 99: 958-68
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    Assane Ndiaye, Souleymane Diatta, David Douglas Banga Nkomo, Papa Salmane Ba, Modibo Doumbia, et al. (2017). Thoracoplasty in the Management of Chronic Empyema: Experience of a Sub Saharan African Country. International Journal of Cardiovascular and Thoracic Surgery, 3(6), 70-74. https://doi.org/10.11648/j.ijcts.20170306.12

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    Assane Ndiaye; Souleymane Diatta; David Douglas Banga Nkomo; Papa Salmane Ba; Modibo Doumbia, et al. Thoracoplasty in the Management of Chronic Empyema: Experience of a Sub Saharan African Country. Int. J. Cardiovasc. Thorac. Surg. 2017, 3(6), 70-74. doi: 10.11648/j.ijcts.20170306.12

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    AMA Style

    Assane Ndiaye, Souleymane Diatta, David Douglas Banga Nkomo, Papa Salmane Ba, Modibo Doumbia, et al. Thoracoplasty in the Management of Chronic Empyema: Experience of a Sub Saharan African Country. Int J Cardiovasc Thorac Surg. 2017;3(6):70-74. doi: 10.11648/j.ijcts.20170306.12

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  • @article{10.11648/j.ijcts.20170306.12,
      author = {Assane Ndiaye and Souleymane Diatta and David Douglas Banga Nkomo and Papa Salmane Ba and Modibo Doumbia and Adama Sawadogo and Magaye Gaye and Fokalbo Zephanie Kobe and Momar Sokhna Diop and Ndeye Fatou Sow and Gabriel Amadou Ciss and Pape Adama Dieng and Mohamadou Lamine Fall and Mouhamadou Ndiaye},
      title = {Thoracoplasty in the Management of Chronic Empyema: Experience of a Sub Saharan African Country},
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {3},
      number = {6},
      pages = {70-74},
      doi = {10.11648/j.ijcts.20170306.12},
      url = {https://doi.org/10.11648/j.ijcts.20170306.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20170306.12},
      abstract = {Introduction: The current main indication of thoracoplasty is empyema following or not lung resection, when the other surgical methods such as thoracic drainage, pleurostomy and/or pulmonary decortication have failed or are not useful. The authors report the role of thoracoplasty in the management of chronic empyema. Method: Between 2004 and 2015, eight male patients underwent thoracoplasty, in the Department of Thoracic Surgery at the University Hospital of Fann, Dakar, Senegal. The mean age was 40 years old. In all cases, the first step of the treatment was thoracic drainage with Heimlich valve in an ambulatory patient, associated with antibiotic according to the result of bacterial culture. In three patients, thoracostomy was indicated to control local infection before thoracoplasty. Results: Indications for thoracoplasty were refractory post resectionnal lung empyema in 6 cases and chronic primary apical empyema in 2 cases. Bronchopleural fistula was found in 5 patients. We performed three superior partial thoracoplasty, and five enlarged thoracoplasty. A myoplasty, using latissimus dorsi to fill the empyema space, was associated with thoracoplasty in five cases. Bronchopleural fistula cure consisted of a direct X form suture in two cases and of intercostal muscle apposition on the fistula in others ones. Partial scapulectomy, by resection of the inferior third part of the scapula was done in three patients. After a mean follow up of one year, no patient presented with persistence or recurrence of empyema. Then we concluded that they were healed. Conclusion: Thoracoplasty is an efficient procedure for the management of chronic empyema. So it is necessary for each team to established define criteria that will allow a patient to undergo thoracoplasty in order to do not use it for any desperate case of refractory chronic empyema.},
     year = {2017}
    }
    

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  • TY  - JOUR
    T1  - Thoracoplasty in the Management of Chronic Empyema: Experience of a Sub Saharan African Country
    AU  - Assane Ndiaye
    AU  - Souleymane Diatta
    AU  - David Douglas Banga Nkomo
    AU  - Papa Salmane Ba
    AU  - Modibo Doumbia
    AU  - Adama Sawadogo
    AU  - Magaye Gaye
    AU  - Fokalbo Zephanie Kobe
    AU  - Momar Sokhna Diop
    AU  - Ndeye Fatou Sow
    AU  - Gabriel Amadou Ciss
    AU  - Pape Adama Dieng
    AU  - Mohamadou Lamine Fall
    AU  - Mouhamadou Ndiaye
    Y1  - 2017/12/06
    PY  - 2017
    N1  - https://doi.org/10.11648/j.ijcts.20170306.12
    DO  - 10.11648/j.ijcts.20170306.12
    T2  - International Journal of Cardiovascular and Thoracic Surgery
    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
    SP  - 70
    EP  - 74
    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20170306.12
    AB  - Introduction: The current main indication of thoracoplasty is empyema following or not lung resection, when the other surgical methods such as thoracic drainage, pleurostomy and/or pulmonary decortication have failed or are not useful. The authors report the role of thoracoplasty in the management of chronic empyema. Method: Between 2004 and 2015, eight male patients underwent thoracoplasty, in the Department of Thoracic Surgery at the University Hospital of Fann, Dakar, Senegal. The mean age was 40 years old. In all cases, the first step of the treatment was thoracic drainage with Heimlich valve in an ambulatory patient, associated with antibiotic according to the result of bacterial culture. In three patients, thoracostomy was indicated to control local infection before thoracoplasty. Results: Indications for thoracoplasty were refractory post resectionnal lung empyema in 6 cases and chronic primary apical empyema in 2 cases. Bronchopleural fistula was found in 5 patients. We performed three superior partial thoracoplasty, and five enlarged thoracoplasty. A myoplasty, using latissimus dorsi to fill the empyema space, was associated with thoracoplasty in five cases. Bronchopleural fistula cure consisted of a direct X form suture in two cases and of intercostal muscle apposition on the fistula in others ones. Partial scapulectomy, by resection of the inferior third part of the scapula was done in three patients. After a mean follow up of one year, no patient presented with persistence or recurrence of empyema. Then we concluded that they were healed. Conclusion: Thoracoplasty is an efficient procedure for the management of chronic empyema. So it is necessary for each team to established define criteria that will allow a patient to undergo thoracoplasty in order to do not use it for any desperate case of refractory chronic empyema.
    VL  - 3
    IS  - 6
    ER  - 

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Author Information
  • Department of Thoracic and Cardiovascular Surgery, University Hospital of Fann, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, University Hospital of Fann, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, University Hospital of Fann, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, University Hospital of Fann, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, University Hospital of Fann, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, University Hospital of Fann, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, University Hospital of Fann, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, University Hospital of Fann, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, University Hospital of Fann, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, University Hospital of Fann, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, University Hospital of Fann, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, University Hospital of Fann, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, University Hospital of Fann, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery, University Hospital of Fann, Dakar, Senegal

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