Pleurocutaneous flap: how useful it is in management of chronic empyema.

BACKGROUND: Definitive surgical treatment of chronic empyema is associated with considerable morbidity and mortality. Methods. Retrospective study of 50 patients with chronic empyema who underwent pleurocutaneous flap procedure during the period 1994 to 2003. RESULTS: Their age ranged from 14 to 70 years; there were 32 males. Thirty-seven (74%) patients were on intercostal tube drainage; nine (18%) presented with bronchopleural fistula; and four (8%) had past-pneumonectomy empyema. Following pleurocutaneous flap procedure, 28 (56%) responded with re-expansion of the lung; 15 (30%) had persistence of pus discharge and air-leak suggestive of bronchopleural fistula. Definitive surgery could be undertaken in nine of the 15 patients. CONCLUSIONS: Pleurocutaneous flap procedure renders the patient ambulatory, facilitates re-expansion of the lung and helps as a tide-over procedure before definitive surgery in patients with chronic empyema.

Pulmonary Resections - Jammu Experience

Ten year registry of patients who underwent pulmonary resections at CTVS section of Govt Medical College Jammu is being presented. The cohort consisted of 94 patients operated between1994-2004. Males outnumbered females in this series Most number (30/94) of patients presented in the 4th decade. Etiology wise, Infective lung diseases were the leading causes leading to pulmonary resections, this included bronchiectasts with 32/94, chronic empyema in6/94 and middle lobe syndrome in one patient. Lung tumors were the causative factors in 20 and post tuberculosis destroyed lung in 17 cases. Two patients presented with intralobar lung sequestrations and one each with pulmonary blastoma and teratoma. The spectrum of resections included right pneumonectomy in19/94 followed by right and left lower lobectomies in 18 each. Thirteen patients underwent left pneumonectomy, 7 bilobectomy and 4 lingulectomy respectively. The mortality in our series was 6/94,20 patients had wound infection, 9 had bronchopleural fistula and 3 postoperative space infections.3 patients were reexplored because of hemorrhage in immediate postoperative period. Diagnostic video assisted thoracoscopy has been started and was employed in 6 patients.