Display options
Cite
Shinohara S, Chikaishi Y, Kuwata T, et al. Benefits of using omental pedicle flap over muscle flap for closure of open window thoracotomy. J Thorac Dis. 2016;8(7):1697-703doi: 10.21037/jtd.2016.05.91.
Shinohara, S., Chikaishi, Y., Kuwata, T., Takenaka, M., Oka, S., Hirai, A., Imanishi, N., Kuroda, K., & Tanaka, F. (2016). Benefits of using omental pedicle flap over muscle flap for closure of open window thoracotomy. Journal of thoracic disease, 8(7), 1697-703. https://doi.org/10.21037/jtd.2016.05.91
Shinohara, Shuichi, et al. "Benefits of using omental pedicle flap over muscle flap for closure of open window thoracotomy." Journal of thoracic disease vol. 8,7 (2016): 1697-703. doi: https://doi.org/10.21037/jtd.2016.05.91
Shinohara S, Chikaishi Y, Kuwata T, Takenaka M, Oka S, Hirai A, Imanishi N, Kuroda K, Tanaka F. Benefits of using omental pedicle flap over muscle flap for closure of open window thoracotomy. J Thorac Dis. 2016 Jul;8(7):1697-703. doi: 10.21037/jtd.2016.05.91. PMID: 27499959; PMCID: PMC4958781.
Copy Download .nbib Format: NLM
Share it on

J Thorac Dis. 2016 Jul;8(7):1697-703. doi: 10.21037/jtd.2016.05.91.

Benefits of using omental pedicle flap over muscle flap for closure of open window thoracotomy.

Journal of thoracic disease

Shuichi Shinohara, Yasuhiro Chikaishi, Taiji Kuwata, Masaru Takenaka, Soichi Oka, Ayako Hirai, Naoko Imanishi, Koji Kuroda, Fumihiro Tanaka

Affiliations

  1. Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.

PMID: 27499959 PMCID: PMC4958781 DOI: 10.21037/jtd.2016.05.91

Abstract

BACKGROUND: Open window thoracotomy (OWT) as well as its closure are challenging. Transposition of omental pedicle and muscle flaps is often performed for OWT closure; however, the better technique among the two is unknown. The purpose of this series was to evaluate the outcomes of using both omental pedicle and muscle flaps for the aforementioned closure.

METHODS: This was an observational retrospective cohort study on 27 consecutive patients who underwent OWT closure at a single institution between January 2005 and December 2014. The operation was performed using either omental pedicle or muscle flap with thoracoplasty. We compared both techniques in terms of the patient background [sex, age, body mass index (BMI) and C-reactive protein (CRP) before OWT and serum albumin levels before OWT closure], presence of methicillin-resistant Staphylococcus aureus (MRSA) infection, rate of bronchopleural fistula (BPF), duration of OWT, recurrence of local infection, morbidity, duration of indwelling drainage after operation, success, mortality and postoperative hospital stay.

RESULTS: There were 9 (33.3%) omental pedicle flap procedures and 18 (66.7%) muscle flap procedures. The rate of local recurrence after closure of OWT was significantly higher with muscle flap than with omental pedicle flap (0% vs. 50.0%, P=0.012). The median duration of postoperative hospital stay was significantly shorter with omental pedicle flap than that with muscle flap (16.0 vs. 41.5 days, P=0.037). Mortality was observed in 2 patients (11.2%) in the muscle flap group and no patient in the omental pedicle flap group. Success rate was similar between the two groups (100% for omental pedicle flap vs. 83.3% for muscle flap).

CONCLUSIONS: Omental pedicle flap was superior to muscle flap in terms of reducing local recurrence and shortening postoperative hospital stay. However, mortality, morbidity and success rates were not affected by the choice of flap.

Keywords: Open window thoracotomy (OWT); closure; empyema; muscle; omentum

References

  1. Eur J Cardiothorac Surg. 1998 Aug;14(2):123-6 - PubMed
  2. Ann Thorac Surg. 1998 Nov;66(5):1782-6 - PubMed
  3. J Thorac Cardiovasc Surg. 1983 Dec;86(6):818-22 - PubMed
  4. Ann Thorac Surg. 2005 Jun;79(6):1857-61 - PubMed
  5. Thorax. 1979 Dec;34(6):740-5 - PubMed
  6. Ann Thorac Surg. 1998 Mar;65(3):818-22 - PubMed
  7. Eur J Cardiothorac Surg. 1999 Apr;15(4):465-8 - PubMed
  8. QJM. 1996 Apr;89(4):285-9 - PubMed
  9. J Thorac Cardiovasc Surg. 1990 Jun;99(6):958-66; discussion 966-8 - PubMed
  10. Am J Respir Crit Care Med. 1999 Nov;160(5 Pt 1):1682-7 - PubMed
  11. Ann Thorac Surg. 2011 Jan;91(1):263-8 - PubMed
  12. Eur J Cardiothorac Surg. 2010 May;37(5):1215-20 - PubMed
  13. Ann Thorac Surg. 2006 Jul;82(1):288-92 - PubMed
  14. Eur J Cardiothorac Surg. 1994;8(3):122-4 - PubMed
  15. Surg Today. 2014 Mar;44(3):443-8 - PubMed
  16. J Thorac Cardiovasc Surg. 2000 Aug;120(2):270-5 - PubMed
  17. Chest. 1991 May;99(5):1162-5 - PubMed
  18. Ann Thorac Surg. 1996 Jun;61(6):1626-30 - PubMed
  19. Gen Thorac Cardiovasc Surg. 2008 Oct;56(10):483-9 - PubMed
  20. Kyobu Geka. 2003 Nov;56(12):989-94; discussion 994-6 - PubMed

Publication Types