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At least 1,477 records · Page 82Linked to original sources
PubMed1991

[Thoracopleuromyoplasty as definitive cure for chronic pleural empyemas, after preparation by open thoracostomy].

Between 1979 and 1986, 30 patients with chronic pleural empyema (19 with pyothorax secondary to tuberculosis and 11 with pleural empyema following pulmonary resection) underwent two-stage treatment. The first stage consisted of open thoracostomy and was followed, 2 to 7 months later, by thoracopleuromyoplasty with latissimus dorsi, serratus anterior and pectoralis major muscles either alone or in combination. There was no operative mortality in this series of 30 operated patients. Definitive obliteraion of the pleural cavity and closure of the bronchial fistulae were obtained in 26 of the 30 patients. Partial necrosis of the muscle graft in the other 4 patients required further open drainage and an additional myoplasty. The long-term functional results in the cases of post-resection empyema were compatible with the restriction created by the pulmonary resection and, in the cases of empyema with a residual lung, with the restriction of the volume and perfusion of pulmonary parenchyma.

Adolescent↗
PubMed1991

[Thoracomyoplastic operations in the surgery of tuberculosis of the lungs].

Different variants of thoracomyoplasty were performed on 532 patients with fibrous-cavernous tuberculosis and tuberculous empyema of the pleura. Treatment outcomes have shown that the range of applications of thoracomyoplastic procedures is wide enough: (1) as an independent procedure; (2) as prevention of postresection complications; and (3) as one-stage method to eliminate caverns and empyemas in the presence of bronchial, esophageal, thoracic fistulas and defects of the chest wall. Improvement of the operative technique, application of new technical means enable one to increase the efficacy of surgical treatment of patients with common and complicated tuberculosis of the respiratory organs and chronic non-specific diseases of the lungs.

Humans↗
PubMed1991

[Various possibilities of reconstruction of the thoracic wall in radiation defects].

Reconstruction of the thoracic wall is often necessary after cancer surgery of the breast or irradiation. The resulting large defects often cause an instable thoracic wall. To reconstruct stability, we can use fascia or dura mater. The large defects can be closed either by latissimus flap, or, if the thoracodorsal artery is destroyed, which is often the case by rotating flaps according to the technique of Schrudde or Bohmert, in very rare cases by distant flaps from the neighbouring upper arm.

Humans↗
PubMed1991

[Reconstructive methods of the antero-lateral thoracic wall after extensive surgery of invasive tumors].

Local recurrence after conservative or enlarged surgery for breast carcinoma, or primary chest wall's tumors should first be approached surgically, chimio- and radiotherapy being used only later on. A precise local and general evaluation has to be made first, trying to determine whether there is or not an invasion of bony structures. When they are free of tumor, regional transfer of musculocutaneous flaps can usually cover the defect (latissimus dorsi, 1-2 rectus abdomini, pectoralis major); great omentum is used when this defect is too large. When ribs, sternum or deep structures are invaded, reconstruction uses successively: a mersilene mesh, bone cement, an omental flap covered with mesh skin grafts 2 days later. Surgical management of these difficult situations is most of the time only a palliative measure which gives these patients a better quality of life for the short time they still have got.

Breast Neoplasms↗
PubMed1991

[Prosthetic material in thoracic wall reconstruction].

For closing a big defect of the chest well the use of prosthetic material can be considered if there is not enough viable tissue of sufficient strength and size available. This synthetic material should be strong, stable, flexibel and inert, and it should be integrated in the body's own tissue. A mersilene netting fulfils these criteria. For covering the netting the greater omentum is preferred for its many valuable properties. The technique and the application of this combined network plasty is described.

Breast Neoplasms↗
PubMed1991

[Preservation of pulmonary function by chest wall reconstruction].

Thirteen mongrel dogs were resected 4 ribs with surrounding tissue. Eight dogs had the chest wall closed by skin alone, and in five animals, the chest wall reconstructed by a polyethylene mesh or marlex sandwich. In the latter PaO2 was significantly higher than that of animals not undergoing reconstruction 3 days after operation. Pulmonary function was appeared to be preserved by reconstruction. Clinically, 68 cases underwent chest wall resection and in 28 cases, defects were reconstructed. Although only portions of 1 or 2 ribs were resected in the non-reconstructed cases, VC, FEV1, and TLC significantly dropped post-operatively. In the reconstructed cases, VC significantly dropped postoperatively. Post-operative complications occurred in 3.6% of the reconstructed cases and in 9.8% of the non-reconstructed cases. Since only 1 rib resection led to reduced ventilatory function clinically, reconstruction for small chest wall defects appears advisable for maintaining pulmonary function.

Adolescent↗
PubMed1990

[Surgical therapy of chronic pyothorax].

A series of 224 patients with chronic pyothorax were treated in our hospital from 1959 to 1985. This paper reported the cure rate, relapse rate and quality of life after operation. One of the 224 patients died from shock within 24 hours after operation. 197 patients cuts (91.6%) healed within one month after operation, but 63 patients had recurrence of pyothorax, abscess of thoracic wall or fistula within three years after operation. By re-operation and/or local drug treatment, 49 of the 63 patients healed, comparing the living activity before and after operation in 96 patients showed that the surgical intervention might give them some improvement.

Adolescent↗
PubMed1990

[Surgical treatment of metapneumonic pleural empyema].

During a period of 13 years 54 patients have been treated for metapneumonic pleural empyema, namely 3 children (all boys), 31 men and 20 women. One patient was admitted in extremis heavily intoxicated after unsuccessful attempt at closed drainage. He died during thoracotomy for open drainage. All the remaining 53 patients were cured, 3 out of 18 by closed thoracostomy (Bülau), 12 out of 16 by open drainage and 37 by decortication which had to be combined with pulmonary resection 13 times. Local treatment of pleural empyema is aimed at the obliteration of the pleural space. This goal can best be accomplished: in the acute exudative stage of the disease (according to the American Thoracic Society) by closed thoracotomy, in the fibrino-purulent phase by open thoracotomy with rib resection and in the chronic organizing stage by decortication.

Adolescent↗
PubMed1989

[Modified Ravitch operation in the treatment of patients with funnel chest].

The characteristic traits of funnel chest have been presented and the clinical results of surgical treatment in 13 patients by the modified Ravitch method have been discussed. Nine results were excellent and four results were good. A marked improvement of general physical function of the patients due to the increase of respiratory system efficiency and a good cosmetic effect were found. The modification of the operation consists in additional longitudinal osteotomy of the sternum, suturing of the manubrium to the sternum shaft, non-suturing of the rib cartilages after resection, filling of the through-like groove in the reposited sternum with the fragments of the resected rib cartilages, and immobilization of the fragments of the longitudinally osteotomized sternum that are inserted crosswise with several (usually three) Kirschner wires, based on the thorax.

Adolescent↗
PubMed1989

[A case of the successful surgical treatment of mediastinal giant neurogenic tumor, and the chest wall reconstruction by the autologous ribs].

A mediastinal tumor, particularly a neurogenic tumor, sometimes develops into a giant tumor; this large tumor mass then puts pressure on the heart and lungs, and may cause severe complications. In our department, 164 mediastinal tumors were experienced, the largest one was an intrathoracic fibromyoma which weighed 3,760 g. This report deals with our recent experience in which we found a neurogenic tumor weighed out 4,500 g. This tumor was excised in an emergency operation, after which the patient's life was saved by twenty-two days of artificial respiration. Since this tumor was so large, four entire right ribs had to be removed in order to create enough space to excise it. In order to reconstruct the chest wall, three of the removed ribs were retransplanted in their original sites. An extremely good prognosis resulted.

Adult↗