Staged removal of artificial patches for thoracic empyema after extrapleural pneumonectomy for diffuse malignant pleural mesothelioma

A 69-year-old man with occupational exposure to asbestos was referred to our hospital with right diffuse malignant pleural mesothelioma. He underwent extrapleural pneumonectomy with reconstruction of the pericardium and diaphragm using elongated polytetrafluoroethylene patches, followed by postopera...

Full description

Saved in:
Bibliographic Details
Published in:General thoracic and cardiovascular surgery 2022-02, Vol.70 (2), p.193-196
Main Authors: Sonobe, Makoto, Kou, Yuuki, Yamazaki, Nobuhisa, Sakaguchi, Yasuto, Tanaka, Hirokazu
Format: Article
Language:English
Subjects:
Abscesses
Aged
Antibiotics
Cardiac Surgery
Cardiology
Case Report
Chemotherapy
Chest tubes
Conflicts of interest
Debridement
Diaphragm (Anatomy)
E coli
Empyema, Pleural - etiology
Empyema, Pleural - surgery
Fistula
Gastrointestinal surgery
Hemodynamics
Humans
Infections
Liver
Male
Medical prognosis
Medicine
Medicine & Public Health
Mesothelioma
Mesothelioma - surgery
Mesothelioma, Malignant
Nutritional status
Pericardium
Pleural effusion
Pleural Neoplasms - surgery
Pneumonectomy
Pneumonectomy - adverse effects
Prostheses
Radiation
Surgical Oncology
Thoracic Surgery
Tomography
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A 69-year-old man with occupational exposure to asbestos was referred to our hospital with right diffuse malignant pleural mesothelioma. He underwent extrapleural pneumonectomy with reconstruction of the pericardium and diaphragm using elongated polytetrafluoroethylene patches, followed by postoperative chemotherapy and chest wall irradiation. One year later, he was hospitalized because of a right empyema caused by Escherichia coli infection. As chest drainage and systemic antibiotics did not eliminate the abscess around the artificial patches, a Clagett window was created. To avoid mediastinal and liver overshift into the right thoracic cavity, we only performed partial resection of the diaphragm patch and incision of the artificial pericardium. After 19 days of irrigation and dressing change, the artificial patches were completely removed. Two months later, the patient provided a culture-negative sample and had an improved nutritional status; we therefore performed closure of the Clagett window with thoracoplasty. He did not experience recurrence of empyema.
ISSN:1863-6705
1863-6713
DOI:10.1007/s11748-021-01723-0