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Cardiothoracic Surgery |

Muscle Transposition and Thoracomyoplasty as Re-Redo Procedures

Petre Vlah-Horea Botianu, MD; Alexandru-Mihail Botianu, MD
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University of Medicine and Pharmacy, Tirgu-Mures, Romania


Chest. 2013;144(4_MeetingAbstracts):118A. doi:10.1378/chest.1704432
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Abstract

SESSION TITLE: Unusual Problems and Thoracic Surgical Solutions

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Tuesday, October 29, 2013 at 04:30 PM - 05:30 PM

PURPOSE: The aim of this study is to analyse our experience with thoracomyoplasty as a re-redo procedure for postoperative complications after thoracic surgery.

METHODS: During 01.01.2005-01.01.2013 we used muscle flaps and thoracomyoplasty in 7 patients having a history of at least 2 major procedures performed through thoracotomy (without considering tube-thoracostomy and open-window thoracostomy). In all the cases the indication for the re—reoperation was the presence of an empyema which could not be controlled by the previous procedures. The principle of the procedure was to perform a complete obliteration of the cavity, closure-reinforcement of the bronchial fistulae (4 cases) and primary closure of the new operative wound. We have used flaps or portion of flaps that were intact after the previous thoracotomies (serratus anterior, latissimus dorsi, pectoralis, subscapular and intercostal).

RESULTS: In all the patients we have achieved obliteration of the cavity and per primam wound healing, with hospitalizations ranging between 30 and 51 days and without significant major morbiditiy. An interesting aspect is that 3 cases were diagnosed with TB based on probes taken in our unit; the absence of a correct antituberculous treatment may be an explanation for the unfavourable evolution of these patients.

CONCLUSIONS: Thoracomyoplasty may be a definitive solution in cases with recurrent postoperative complications. A carefull analysis of the local anatomy allows the use of neighbourhood muscle flaps even after more procedures involving opening of the chest.

CLINICAL IMPLICATIONS: An individualized tailored approach based on muscle flaps and thoracomyoplasty may be used as a definitive solution in cases where other procedures failed.

DISCLOSURE: The following authors have nothing to disclose: Petre Vlah-Horea Botianu, Alexandru-Mihail Botianu

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