Local muscle flaps via video-assisted thoracoscopic surgery (VATS) without thoracotomy for dead space obliteration

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• 作者：James E. McCarthy ; Steven J. Kempton…
• 刊名：European Journal of Plastic Surgery
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：39
• 期：4
• 页码：293-296
• 全文大小：509 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Plastic Surgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1435-0130
• 卷排序：39

文摘

The obliteration of intra-thoracic dead space following tumor or empyema extirpation is imperative to successful long-term outcomes. We sought to describe the technique of using a pedicled latissmus dorsi muscle flap for obliteration of a large 14 × 6cm intrathoracic dead space following pleural decortication of chronic empyema, without thoracotomy or rib spreading via video-assisted thoracoscopic surgery (VATS). Specific attention is directed to the technical details of the flap harvest and inset in relation to the modifications required to inset the flap without a thoracotomy or rib spreading. The patient’s history, presenting symptoms, pre-operative imaging, intraoperative details, and post-operative course are delineated with a focus on the length of stay, post-operative pain, and morbidity. The length of stay was 2 days with minimal pain on post-operative day one managed with oral nacrotic; long term post-operative X-ray revealed obliterated dead space and the patient experienced no complications. Inset of pedicled latissmus muscle flaps via VATS technique without thoracotomy or rib spreading seems a safe and effective technique that can offer short hospitalization with minimal pain morbidity.Level of Evidence: Level V, therapeutic studyKeywordsIntra-thoracic reconstructionChest wall reconstructionVATSReconstruction