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Thoracic irrigation for traumatic hemothorax: A systematic review and meta-analysis.
J Trauma Acute Care Surg
November 2024
From the Divisions of Trauma, Surgical Critical Care, and Burns, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, Miami, Florida.
Article Synopsis
- Traumatic hemothoraces (HTXs) are common injuries managed with tube thoracostomy (TT), but retained HTX can complicate recovery, potentially leading to conditions like fibrothorax or empyema.
- The study reviewed six research studies involving 1,319 trauma patients and found that those who received thoracic irrigation during TT had a significantly lower failure rate (10.7% vs. 18.2%) and shorter hospital stays.
- The conclusion suggests that concurrent TT and thoracic irrigation can reduce retained HTX rates, although more randomized studies are needed to establish formal treatment guidelines.
Long-term outcomes in surgically intervened empyema patients: a systematic review.
ANZ J Surg
September 2024
Department of Thoracic Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Article Synopsis
- Pleural empyema is a serious condition that affects patient health, and recent studies suggest that surgical intervention might offer better short-term results, but the long-term effects are less understood.
- A systematic review of 11 studies found that while surgical patients showed improvements in lung function and reduced dyspnoea after 2-7 years, the quality of life and comparisons to other treatments were lacking due to significant bias in the studies.
- The conclusion emphasizes the need for better-designed prospective trials to accurately assess the long-term benefits of surgical intervention for pleural empyema.
Left-sided fibrothorax: a sequela of chronic tubercular empyema.
Pan Afr Med J
June 2024
Department of Respiratory Medicine, Datta Meghe Medical College, Nagpur, Datta Meghe Institute of Higher Education and Research (DMIHER) Deemed University (DU), Sawangi (Meghe), Wardha, India.
Treatment of late left bronchopleural fistula after left pneumonectomy through right thoracic approach assisted by extracorporeal membrane oxygenation.
J Cardiothorac Surg
May 2024
Department of Cardiothoracic Surgery, Zhongshan City People's Hospital, No.2 Sunwen Dong Road, Zhongshan, Guangdong Province, China.
Background: Bronchopleural fistula (BPF) is a rare but fatal complication after pneumonectomy. When a BPF occurs late (weeks to years postoperatively), direct resealing of the bronchial stump through the primary thoracic approach is challenging due to the risks of fibrothorax and injury to the pulmonary artery stump, and the surgical outcome is generally poor. Here, we report a case of late left BPF following left pneumonectomy successfully treated using a right thoracic approach assisted by extracorporeal membrane oxygenation (ECMO).
View Article and Find Full Text PDFPleural Diseases in Connective Tissue Diseases.
Semin Respir Crit Care Med
June 2024
Oxford Respiratory Trials Unit, Oxford Centre for Respiratory Disease, Oxford University Hospital, Oxford Centre for Respiratory Medicine, Churchill Hospital, NHS Trust, Oxford, United Kingdom.
Connective tissue diseases (CTD) are heterogeneous, immune-mediated inflammatory disorders often presenting with multiorgan involvement. With the advent of high-resolution computed tomography, CTD-related pleuritis-pleural thickening and effusion-is now increasingly recognized early in the disease trajectory. The natural history of CTD-related pleural effusions varies from spontaneous resolution to progressive fibrothorax with ventilatory impairment.
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