Triple plastie de comblement d'une thoracostomie de clagett

ABSTRACT

Clagett's thoracostomy is a widely used procedure in the initial treatment of postpneumonectomy empyema. We describe in this paper an original one step operation of thoracic filling after empyema sterilization. The triple plasty includes an apical thoracoplasty limited to the first 3 ribs, a pedicle flap of the latissimus dorsi transferred inside the thoracic cavity and an upper translation of the diaphragm to the 4th rib in order to reduce resiual pleural space. Three patients were operated and followed up clinically [for 20, 29 and 30 months], and radiologically with a MRI on the 12th months. Complete tissue healing and loss of all residual space was observed in all patients. We therefore recommend the use of this technique rather than thoracic wall coverage procedures