Osteoplastic thoracomyoplastics as a variant of surgical treatment of the post-pneumonectomes empyema, when it is possible to preserve the shell of thorax

Abstract

After 5-year experience of pneumonectomy (2011–2015), we have analyzed the cases of complicated postoperative period and the ways to do with complications. We have performed 136 pneumonectomies. Complications were registered in 30 cases (22%). The main complications were empyema of post-operative thoracic cavity, insolvency of the mane bronchial tubes suture, which in some cases formed a bronchial fistula. Post-operation bleeding was rare (two cases); there was one case of hylothorax. In 28 complicated cases of pneumonectomy, we had to re-operate the patients but there were only two cases when the rethoracotomy itself was enough. The main method of treatment was thoracostomy followed by thoracomyoplastics, or thoracoplastics with drainage of postoperative thoracic cavity. Most of the patients operated (average age 30–35 years) had TB. For the young people whose aim is to socialize in society it is very important not only to preserve life and health but to avoid the post-operative deformation of thorax caused by 8–9 ribsthoracoplastics. This kind of operation performed in 25 cases. The new method of osteoplastic thoracomyoplastics makes it possible to minimize the defect of thorax and create the conditions for liquidation of the post-operative thoracic cavity. During the period described we have managed to perform one operation, one more was done in 2016 with no recidive of empyema.