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      저자 : Rajkamal Vishnu (검색결과 1 건)
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        Modus Operandi: Irrigation of the Modified Eloesser Flap in Heterogeneous Suppurative Lung Pathologies

        Rajkamal Vishnu,Guruprasad D. Rai,Ganesh Sevagur Kamath,Vijaya Kumara 대한흉부외과학회 2021 Journal of Chest Surgery (J Chest Surg) Vol.54 No.2

        Background: Refractory empyemas with collapsed lung and persistent bronchopleural fistulas pose significant problems to thoracic surgeons and impose a substantial burden in terms of morbidity and mortality. The modified Eloesser flap procedure is a useful palli- ative option for clearing infections. Herein, we present our experiences with the modified Eloesser flap procedure in mixed suppurative lung pathologies with a new technique of irrigation for persistent infection. Methods: A retrospective review was carried out of 56 patients who underwent the modified Eloesser flap with continuous irrigation at Katurba Medical College. These pa- tients had severe morbidities and were not suitable for major thoracic resection surgery, and electively underwent modified Eloesser flap surgery. Regular follow-up was done at 1, 3, 6, and 12 months. Patients with persistent infections were treated with our continuous irrigation technique. Results: The most important finding was that all patients with active sputum acid-fast bacilli–positive findings became sputum smear–negative during the first month of fol- low-up. Half (50%) of the patients had a patent stoma. Eleven patients had persistent infec- tions, necessitating continuous irrigation. The infection was fully cleared after 1 month in 9 patients, while 2 patients required second irrigation and continued to receive follow-up. In the remaining 50% of the patients, the stoma closed completely, and the lung expanded fully. Conclusion: The modified Eloesser flap is a simple procedure. In suppurative patholo- gies, infections were well controlled and the general condition of the patients improved. Our continuous irrigation method showed promising results in patients with persistent purulent discharge.

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