eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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4/2020
vol. 15
 
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Thoracic surgery
abstract:
Original paper

Intrathoracic negative pressure therapy and/or endobronchial valve for pleural empyema minimal invasive management: case series of thirteen patients and review of the literature

Siarhei Panko
1
,
Denis Vakulich
2
,
Aliaksandr Karpitski
2
,
Henadzi Zhurbenka
2
,
Andrej Shestiuk
3
,
Rostislav Boufalik
2
,
Aliaksandr Ihnatsiuk
2

1.
Faculty of Health Sciences, Jan Kochanowski University of Humanities and Sciences, Kielce, Poland
2.
Department of Thoracic Surgery, Brest Regional Hospital, Brest, Belarus
3.
Department of Anatomy and Physiology, Brest State University, Brest, Belarus
Videosurgery Miniinv 2020; 15 (4): 588–595
Online publish date: 2020/02/24
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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, one 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.

keywords:

bronchopleural fistula, video-assisted thoracoscopic surgery, empyema, Intrathoracic negative pressure therapy, endobronchial valve

  
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