Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2021; 9(27): 8114-8119
Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8114
Limited thoracoplasty and free musculocutaneous flap transposition for postpneumonectomy empyema: A case report
Qian-Qian Huang, Zhong-Liang He, Yong-Yong Wu, Zhi-Jun Liu
Qian-Qian Huang, Operating Room, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang Province, China
Zhong-Liang He, Yong-Yong Wu, Zhi-Jun Liu, Department of Cardiothoracic Surgery, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang Province, China
Author contributions: Huang QQ, Wu YY and Liu ZJ were the patient’s cardiothoracic surgeons and nurse, reviewed the literature and contributed to manuscript drafting; He ZL was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report and the accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised accordingly.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong-Liang He, MD, Chief Doctor, Director, Surgeon, Department of Cardiothoracic Surgery, Tongde Hospital of Zhejiang Province, No. 234 Gucui Road, Hangzhou 310012, Zhejiang Province, China. doctorhzl@163.com
Received: April 10, 2021
Peer-review started: April 10, 2021
First decision: May 11, 2021
Revised: May 24, 2021
Accepted: August 12, 2021
Article in press: August 12, 2021
Published online: September 26, 2021
Processing time: 159 Days and 3.8 Hours
Abstract
BACKGROUND

Empyema is a severe complication following pneumonectomy that is associated with high morbidity and mortality rates. Although there are a wide variety of treatment options, successful management remains challenging when this condition is combined with a large cavity in very thin patients who had previously undergone a posterolateral thoracotomy.

CASE SUMMARY

We reported the case of a thin, 63-year-old man with a progressive pulmonary cyst who underwent left pneumonectomy via posterolateral thoracotomy 23 years ago. After an initially uneventful postoperative course, he was readmitted with empyema and a large cavity 21 years after surgery. He was successfully treated with limited thoracoplasty, followed by free vastus lateralis musculocutaneous flap transposition.

CONCLUSION

This case highlights that the treatment mode of limited thoracoplasty and free vastus lateralis musculocutaneous flap transposition is safe and effective for the management of postpneumonectomy empyema with a large cavity in thin patients who had previously undergone a posterolateral thoracotomy.

Keywords: Pneumonectomy; Postpneumonectomy empyema; Thoracoplasty; Free muscle flap; Surgical treatment; Case report

Core Tip: Empyema is a severe complication following pneumonectomy and is associated with high morbidity and mortality rates. Although there are a wide variety of treatment options, successful management remains challenging. We performed limited thoracoplasty and free vastus lateralis musculocutaneous flap transposition for postpneumonectomy empyema with a large cavity in a thin patient who had previously undergone a posterolateral thoracotomy. This treatment mode is safe and effective for such patients.