Thoracoscopic pleural lavage for empyema after liver transplantation

doi:10.3877/cma.j.issn.2095-3232.2015.02.009

Abstract

Abstract:

Objective

To explore the application value of thoracoscopic pleural lavage for empyema after liver transplantation (LT).

Methods

Clinical data of 5 patients who underwent thoracoscopic pleural lavage for empyema after LT in the Third Affiliated Hospital of Sun Yat-sen University from October 2002 to October 2013 were analyzed retrospectively. All 5 patients were males with the age ranging from 42 to 56 years old and the median of 51 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients received thoracoscopic pleural lavage for empyema under endotracheal general anesthesia. The thoracoscope was introduced in the seventh intercostal space on the mid-axillary line. The aspirator was inserted in the third intercostal space on the anterior line to drain the pus. And the pleural fiberboard was peeled off. The intraoperative situation and perioperative recovery of the patients were observed.

Results

Five patients received successful operations and recovered and were discharged from hospital. The median length of operation was 2(1-3) h. The length of respirator assisted ventilation was 26(6-42) h. The intraoperative blood loss was 600(300-1 000) ml. The length of indwelling chest drainage tube was 4(2-6) h. The volume of chest drainage was 680(350-1 200) ml. No mortality, empyema recurrence and other serious complications were observed. The postoperative hospital stay was 7(5-11) d.

Conclusion

Thoracoscopic pleural lavage for empyema after LT is a safe and effective treatment.

Key words: Liver transplantation, Postoperative complications, Empyema, pleural, Prognosis

Songwang Cai, Libao Liu, Yimin Weng, Shaohong Huang, Jun An, Jun Li, Huiguo Chen, Jinyuan He, Shen Lao, Junhang Zhang, Hongying Liao. Thoracoscopic pleural lavage for empyema after liver transplantation[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2015, 04(02): 97-99.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhgzwkssxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3232.2015.02.009

https://zhgzwkssxdzzz.cma-cmc.com.cn/EN/Y2015/V04/I02/97

References 17

[1]	Light RW. Pleural effusions[J]. Med Clin N Am, 2011, 95(6):1055-1070.
[2]	Nelson JS, Jackson AL, Darling JM, et al. Chest pain and progressive shortness of breath in a 60-year-old woman following liver transplantation[J]. Chest, 2011, 139(2):464-468.
[3]	Loirat C, Saland J, Bitzan M. Management of hemolytic uremic syndrome[J]. Presse Med, 2012, 41(3Pt2):e115-135.
[4]	Thomas R, Lee YC. Causes and management of common benign pleural effusions[J]. Thorac Surg Clin, 2013, 23(1):25-42.
[5]	Harris K, Chalhoub M. The use of a PleurX catheter in the management of recurrent benign pleural effusion: a concise review[J]. Heart Lung Circ, 2012, 21(11):661-665.
[6]	Koegelenberg CF, Diacon AH. Pleural controversy: closed needle pleural biopsy or thoracoscopy:which first?[J]. Respirology, 2011, 16(5):738-746.
[7]	Sahn SA. Getting the most from pleural fluid analysis[J]. Respirology, 2012, 17(2):270-277.
[8]	Davies HE, Rosenstengel A, Lee YG. The diminishing role of surgery in pleural disease[J]. Curr Opin Pulm Med, 2011, 17(4):247-254.
[9]	Kiberd B, Skedgel C, Alwayn I, et al. Simultaneous liver kidney transplantation: a medical decision analysis[J]. Transplantation, 2011, 91(1):121-127.
[10]	Chen CH, Shih CM, Chou JW, et al. Outcome predictors of cirrhotic patients with spontaneous bacterial empyema[J]. Liver Int, 2011, 31(3):417-424.
[11]	Cordero E, Pérez-Romero P, Moreno A, et al. Pandemic influenza A (H1N1) virus infection in solid organ transplant recipients: impact of viral and non‐viral co‐infection[J]. Clin Microbiol Infect, 2012, 18(1):67-73.
[12]	Ravaglia C, Gurioli C, Tomassetti S, et al. Is medical thoracoscopy efficient in the management of multiloculated and organized thoracic empyema?[J]. Respiration, 2012, 84(3):219-224.
[13]	Harps E, Brinkert F, Ganschow R, et al. Immediate postoperative intensive care treatment of pediatric combined liver-kidney transplantation: outcome and prognostic factors[J]. Transplantation, 2011, 91(10):1127-1131.
[14]	Zahid I, Nagendran M, Routledge T, et al. Comparison of video-assisted thoracoscopic surgery and open surgery in the management of primary empyema[J]. Curr Opin Pulm Med, 2011, 17(4):255-259.
[15]	Kumar S, Sarin SK. Paradigms in the management of hepatic hydrothorax: past, present, and future[J]. Hepato Int, 2013, 7(1):80-87.
[16]	Mcgrath EE, Anderson PB. Diagnosis of pleural effusion: a systematic approach[J]. Am J Crit Care, 2011, 20(2):119-128.
[17]	Froudarakis ME. New challenges in medical thoracoscopy[J]. Respiration, 2011, 82(2):197-200.

Please choose a citation manager

Content to export