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Revista Medica Herediana

Print version ISSN 1018-130XOn-line version ISSN 1729-214X


MAEKAWA YKEHARA, Rosalba Lupe; AMEZ OLIVERA, Jessica Mercedes  and  CASTANEDA SALDANA, Enrique. Ventana torácica en el tratamiento del empiema pleural crónico en el Hospital Nacional Cayetano Heredia, 1990-1998 . Rev Med Hered [online]. 2002, vol.13, n.3, pp.90-98. ISSN 1018-130X.

Objective: To describe outcomes of the thoracic window in the treatment of the pleural empyema. Patients and methods: A descriptive, retrospective and traversal study. Subjected patients were included to thoracic window (thoracostomy), between 1990-1998, in the National Hospital Cayetano Heredia. The surgical treatment was studied (technique, reports and complications), morbility and mortality. We studied 59 cases of thoracic window in patient with chronic empyema. They were 39 (66.1%) males and 20 (33.9%) women. Mean age was 30.9 ± 14 years. Results: According to the etiology, 55.93% had tuberculous pleural empyema, 28.81% empyema post lung surgery, 11.86% empyema post pneumonia and 3.39% empyema post traumatic. 95% of the cases were drainaged previously with tube of thoracostomy. The predominant radiological pattern was the hidroneumotórax (58%). The 64.4% was intervened under regional anaesthesia. The time operative average was of 57.3 ± 28 minutes. The costal arches dried up with more frequency were the 6°-7° (25%). The time average of hospitalization was 38.6 ± 26.9 days; the time postoperative average was 8.5 ± 8.3 days. Of the patients that had a bigger pursuit to 3 months (33 patients), we could confirm the closing of the thoracic window in 13 cases and lung reexpansión in 21 cases. Conclusions: The main indication was the answer lack to the tube of drainage thoracostomy (40%). The main etiology is the tuberculous pleural empyema. It is an ideal procedure for patient severely compromised and immunocompromised patients. The postoperatives complications were 11.86%. The percentage of reoperations was of 3.4%. Mortality associated to the procedure was not reported. ( Rev Med Hered 2002; 13: 90-98).

Keywords : thoracic window; pleural empyema; surgery and complications.

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