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thoracic empyema

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https://www.readbyqxmd.com/read/28304084/surgical-versus-non-surgical-management-for-pleural-empyema
#1
REVIEW
Mark D Redden, Tze Yang Chin, Mieke L van Driel
BACKGROUND: Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment...
March 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28274565/the-american-association-for-thoracic-surgery-consensus-guidelines-for-the-management-of-empyema
#2
K Robert Shen, Alejandro Bribriesco, Traves Crabtree, Chad Denlinger, Joshua Eby, Patrick Eiken, David R Jones, Shaf Keshavjee, Fabien Maldonado, Subroto Paul, Benjamin Kozower
No abstract text is available yet for this article.
February 4, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28273226/parapneumonic-pleural-effusion-reality-and-strategies-in-an-amazon-university-hospital
#3
Claudia Giselle Santos Arêas, Geraldo Roger Normando Júnior, Orlando Sandoval Farias Júnior, Irna Carla DO Rosário Souza Carneiro
OBJECTIVE: to define the profile and analyze the postoperative evolution of children with parapneumonic pleural effusion (PPE), and to evaluate strategies used in the presence of diagnostic and therapeutic limitations, emphasizing the open thoracic drainage (OTD) . METHODS: we conducted a cross-sectional, prospective, analytical study in which we followed children admitted in an Amazon university hospital with surgically addressed PPE, from October 2010 to October 2011...
December 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28259070/effective-treatment-of-empyema-with-bronchopleural-fistula-after-esophagectomy-by-endobronchial-embolization-using-endobronchial-watanabe-spigots
#4
Shinsuke Uchida, Hiroyasu Igaki, Takehiro Izumo, Yuji Tachimori
INTRODUCTION: Empyema and bronchopleural fistula are well known complications after thoracic surgery. We report a case of refractory air leakage of bronchopleural fistula in a patient with empyema that was successfully treated by endobronchial embolization using Endobronchial Watanabe Spigots (EWSs). PRESENTATION OF CASE: A 71-year-old man underwent esophagectomy for primary esophageal cancer. A right empyema with bronchopleural fistula (BPF) developed four months after surgery...
January 24, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28249343/predictors-of-outcome-in-modern-surgery-for-lung-abscess
#5
Michael Schweigert, Norbert Solymosi, Attila Dubecz, Joseph John, Doug West, Paul Leonhard Boenisch, Riyad Karmy-Jones, Carlos F Giraldo Ospina, Ana Beatriz Almeida, Helmut Witzigmann, Hubert J Stein
Background Surgery for lung abscess is a challenging task. Timing and indications for surgery are not well established. Identification of predictors of outcome could help to clarify the role of surgery. Methods Patients who underwent major thoracic surgery for infectious lung abscess were identified at six centers for general thoracic surgery in Germany, Spain, the United Kingdom, and the United States. Study period was 2000 to 2016. Results There were 91 patients. Pulmonary sepsis (48), pleural empyema (43), persistent air leakage (25), acute renal failure (12), and respiratory failure with mechanical ventilation (25) were already preoperatively present...
March 1, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28203426/a-novel-technique-for-chest-drain-removal-using-a-two-layer-method-with-triclosan-coated-sutures
#6
Yujiro Yokoyama, Takahiro Nakagomi, Daichi Shikata, Taichiro Goto
In thoracic surgery, a thoracic drain is always inserted after the surgical procedure. Repair of the wound after removal of the thoracic tube is performed postoperatively, but no universally standard methods currently exists for this tube removal. Here we report a technique using triclosan-coated sutures that is used in thoracic surgery in our hospital. There are several advantages of this technique. First, there is no need for stitches removal on follow-up. Second, it prevents the leakage of pleural exudate because of the tight two-layer sutures...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28147437/analysis-of-risk-factors-in-the-development-of-bronchopleural-fistula-after-major-anatomic-lung-resection-experience-of-a-single-centre
#7
Dania Nachira, Marco Chiappetta, Leonello Fuso, Francesco Varone, Ilaria Leli, Maria T Congedo, Stefano Margaritora, Pierluigi Granone
BACKGROUND: The bronchopleural fistula (BPF) is a rare but potentially fatal complication of major thoracic surgery. The purpose of this work is to investigate the risk factors associated with the development of fistulas after lobectomy and pneumonectomy. METHODS: We retrospectively reviewed the records of 835 patients who underwent major anatomic lung resection at our centre from January 2003 to December 2013. Of these, 49 underwent pneumonectomy (P group) and 786 lobectomy (L group)...
February 1, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28108575/uniportal-thoracoscopic-decortication-for-pleural-empyema-and-the-role-of-ultrasonographic-preoperative-staging%C3%A2
#8
Stefano Bongiolatti, Luca Voltolini, Sara Borgianni, Roberto Borrelli, Giorgia Tancredi, Domenico Viggiano, Alessandro Gonfiotti
OBJECTIVES: The surgical approach to chronic pleural empyema is still controversial. Video-assisted thoracic surgery (VATS) debridement and decortication has shown favourable outcomes, while the uniportal VATS (U-VATS) approach is still anecdotal. We report our experience with ultrasonographic (US) preoperative staging followed by U-VATS decortication for pleural empyema. METHODS: We performed a retrospective analysis of patients who underwent surgical treatment of stage II and stage III pleural empyema from 2012 to 2015...
January 19, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28087049/-the-benefits-of-digital-chest-drainage-in-pleural-decortication-in-thoracic-empyema-prospective-randomized-control-trial
#9
José M Mier, Gildardo Cortés-Julián, Juan Berrios-Mejía, Zotés Víctor-Valdivia
BACKGROUND: Prolonged air leak after pleural decortication is one of the most frequent complications. OBJECTIVE: The aim of this study is to compare the effects of prolonged air leak between the digital chest drainage (DCD) system and the classic drainage system in patients with empyema class IIB or III (American Thoracic Society classification) in pleural decortication patients. MATERIAL AND METHODS: A total of 37 patients were enrolled in a prospective randomized control trial over one year, consisting of 2blinded groups, comparing prolonged air leak as a main outcome, the number of days until removal of chest drain, length of hospital stay and complications as secondary outcomes...
January 10, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28054136/-role-of-imaging-procedures-in-clarification-of-complications-of-pneumonia
#10
K Lampichler
CLINICAL ISSUE: Despite a considerable number of antimicrobial agents and interdisciplinary treatment options, lower respiratory tract infections are still associated with high morbidity and mortality rates. Infections of the respiratory tract can lead to severe complications, such as empyema, lung abscesses and acute respiratory distress syndrome (ARDS). Besides intrapulmonary complications pneumonia can also impair other organs due to a systemic inflammatory response. Underlying cardiovascular diseases, such as chronic heart failure, arteriosclerosis and dysrhythmia can either deteriorate due to infections or be newly manifested as a result of pneumonia...
January 2017: Der Radiologe
https://www.readbyqxmd.com/read/28052108/heme-oxygenase-1-deficiency-diminishes-methicillin-resistant-staphylococcus-aureus-clearance-due-to-reduced-tlr9-expression-in-pleural-mesothelial-cells
#11
Satindra Gahlot, Najmunnisa Nasreen, Judith A Johnson, Steven A Sahn, Kamal A Mohammed
Methicillin Resistant Staphylococcus aureus (MRSA) cause pneumonia and empyema thoraces. TLR9 activation provides protection against bacterial infections and Heme oxygenase-1 (HO-1) is known to enhance host innate immunity against bacterial infections. However, it is still unclear whether HO-1 regulates TLR-9 expression in the pleura and modulates the host innate defenses during MRSA empyema. In order to determine if HO-1 regulates host innate immune functions via modulating TLR expression, in MRSA empyema, HO-1+/+ and HO-1-/- mouse pleural mesothelial cells (PMCs) were infected with MRSA (1:10, MOI) in the presence or absence of Cobalt Protoporphyrin (CoPP) and Zinc Protoporphyrin (ZnPP) or CORM-2 (a Carbon monoxide donor) and the expression of mTLR9 and mBD14 was assessed by RT-PCR...
2017: PloS One
https://www.readbyqxmd.com/read/28049376/management-of-pleural-space-after-lung-resection-by-cryoneuroablation-of-phrenic-nerve
#12
Xiao-Jie Pan, De-Bin Ou, Xing Lin, Ming-Fang Ye
OBJECTIVES: Residual air space problems after pulmonary lobectomy are an important concern in thoracic surgical practice, and various procedures have been applied to manage them. This study describes a novel technique using controllable paralysis of the diaphragm by localized freezing of the phrenic nerve, and assesses the effectiveness of this procedure to reduce air space after pulmonary lobectomy. METHODS: In this prospective randomized study, 207 patients who underwent lobectomy or bilobectomy and systematic mediastinal node dissection in our department between January 2009 and November 2013 were randomly allocated to a cryoneuroablation group or a conventional group...
January 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28003678/usefulness-of-thoracoscopic-debridement-for-chronic-empyema-after-an-extrapleural-pneumonectomy
#13
Hidejiro Torigoe, Shinichi Toyooka, Hiromasa Yamamoto, Junichi Soh, Shinichiro Miyoshi
We present the case of a 65-year-old Japanese man diagnosed with chronic empyema (without a bronchopleural fistula) that occurred 7 months after he underwent an extrapleural pneumonectomy for right malignant pleural mesothelioma (MPM). Following thoracic drainage and irrigation for 1 month, we performed surgery by a thoracoscopic approach, in light of his general condition. We performed debridement and removal of the Gore-Tex polytetrafluoroethylene (PTFE) patch that had been used for the reconstruction of the diaphragm and the pericardium...
December 2016: Acta Medica Okayama
https://www.readbyqxmd.com/read/27984383/hippocrates-quoted-if-an-empyema-does-not-rupture-death-will-occur-is-medical-thoracoscopy-able-to-make-it-rupture-safely
#14
Georgia Hardavella, Nikolaos A Papakonstantinou, Ioannis Karampinis, Gerasimos Papavasileiou, Shereen Ajab, Mohammed Shafaat, Stavros Malagaris, Nikolaos Anastasiou
BACKGROUND: The aim of this study was to evaluate the safety and efficacy of medical thoracoscopy through a single port [single-port medical thoracoscopy (S-MT)] for the treatment of empyema thoracis in its early stages. METHODS: We performed a retrospective analysis reviewing the medical records of 84 patients referred for empyema and treated by medical thoracoscopy at our Thoracic Departments from January 2001 until November 2014. S-MT was performed under local anesthesia with neuroleptoanalgesia and spontaneous breathing using a single 1-cm incision for debridement and lavage of the pleural cavity...
January 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/27904842/the-challenges-of-cardiothoracic-surgery-practice-in-nigeria-a-12-years-institutional-experience
#15
Bode Falase, Michael Sanusi, Adeola Animasahun, Ogadinma Mgbajah, Adetinuwe Majekodunmi, Onyekwelu Nzewi, Jonathan Nwiloh, David Oke
BACKGROUND: Although the specialty of cardiothoracic surgery has been practiced in Nigeria for many years, open heart surgery (OHS) has only in the last decade become relatively more frequent, mainly through visiting foreign cardiac surgical teams. At this early phase of development it is faced with multiple challenges, especially financing and local skilled manpower for which solutions have to be identified in order to ensure sustainability and future growth. This study is aimed at highlighting these obstacles to growth of cardiothoracic surgery based on our own institutional experience at Lagos State University Teaching Hospital (LASUTH) and the current status of OHS activity in other cardiothoracic centers in Nigeria...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27904839/noncardiac-thoracic-surgery-in-abidjan-from-1977-to-2015
#16
Yves Tanauh, Flavien Kendja, Hervé Yangni-Angate, Blaise Demine, Raphaël Ouédé, Maurice Kouacou
BACKGROUND: To report and analyze noncardiac thoracic operations performed at the Cardiology Institute of Abidjan (Institut de Cardiologie d'Abidjan) from 1977 to 2015. METHODS: This is a retrospective and descriptive study covering 39 years, from 1977 to 2015. This study period was divided into three periods of 13 years each: P1 from 1977 to 1989, P2 from 1990 to 2002 and P3 from 2003 to 2015. Medical records of 2014 operated patients were analyzed: 414 patients for P1, 464 patients for P2, 1,136 patients for P3...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27823364/medical-management-of-spinal-epidural-empyema-in-five-dogs
#17
Susana R Monforte Monteiro, Antonella Gallucci, Nicolas Rousset, Paul M Freeman, Edward J Ives, Gualtiero Gandini, Nicolas Granger, An E Vanhaesebrouck
CASE DESCRIPTION 5 dogs were examined because of clinical signs of myelopathy, including signs of pain associated with the spinal region and rapidly progressive neurologic deficits. CLINICAL FINDINGS In all dogs, results of MRI were consistent with spinal epidural empyema. Concurrent infectious processes were identified at adjacent or distant sites in all dogs, including diskospondylitis, prostatitis, dermatitis, paraspinal infection following a penetrating injury, urinary tract infection, and pyothorax. Bacteria were isolated from 3 dogs; Escherichia coli was isolated from blood, urine, and prostatic wash samples from 1 dog; a Pasteurella sp was isolated from a percutaneous aspirate from an adjacent infected wound in a second dog; and a Corynebacterium sp was isolated from a thoracic fluid sample from a third dog...
November 15, 2016: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/27815709/stage-directed-therapy-of-pleural-empyema
#18
REVIEW
Martin Reichert, Matthias Hecker, Biruta Witte, Johannes Bodner, Winfried Padberg, Markus A Weigand, Andreas Hecker
PURPOSE: Intensivists and surgeons are often confronted with critically ill patients suffering from pleural empyema. Due to it' s multifactorial pathogenesis and etiology, medicals should be sensitized to recognize the different stages of the disease. Besides a whole bundle of different established classification systems, the progress of pleural effusions can be subdivided into the early exudative, the intermediate fibropurulent and the late organized phase according to the classification of the American Thoracic Society...
February 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27681234/thoracic-empyema-caused-by-campylobacter-rectus
#19
Tomoyuki Ogata, Teruo Urata, Daisuke Nemoto, Shigemi Hitomi
We report a case of thoracic empyema caused by Campylobacter rectus, an organism considered as a periodontal pathogen but rarely recovered from extraoral specimens. The patient fully recovered through drainage of purulent pleural fluid and administration of antibiotics. The present case illustrates that C. rectus can be a cause of not only periodontal disease but also pulmonary infection.
September 25, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/27660730/the-application-of-vacuum-assisted-closure-device-in-the-management-of-empyema-necessitans
#20
Yasser Aljehani, Zahra Al-Matar, Samah Nawar
Vacuum-assisted closure (VAC) is gaining popularity in the management of many types of acute and chronic wounds. The use of VAC devices in thoracic surgery is limited, but it appears to be promising in complex cases of empyema thoraces. We report a case of empyema necessitans, in which VAC was used to achieve complete wound healing after open drainage which was communicating with the pleural space.
2016: Case Reports in Surgery
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