Bedside Modified Clagett Procedure for Empyema After Pulmonary Resection

Keeling, W. Brent; Garrett, Joseph R.; Vohra, Nasreen; Maxey, Thomas S.; Blazick, Elizabeth; Sommers, Eric
July 2006
American Surgeon;Jul2006, Vol. 72 Issue 7, p627
Academic Journal
The objective of this study is to demonstrate the effectiveness and feasibility in treating empyema after pulmonary resection with a modified Clagett procedure performed at the bedside (BMCP). A retrospective review of a single surgeon's experience at a single institution was undertaken. All operative, postoperative, and outcome data were analyzed. Follow-up data were obtained from subsequent clinic charts. Five patients, including four males, were identified who underwent BMCP after pulmonary resection. The original operative procedures included two lobectomies, one pneumonectomy, one bilobectomy, and one bilateral metastastectomy. Patients were diagnosed with an empyema (positive thoracostomy tube culture, fever, and radiographic abnormality) at a mean time of 31 days from their initial procedure. Culture results disclosed Gram-positive empyemas in all patients. Three patients underwent BMCP as an outpatient, whereas the other two had BMCP during their hospitalizations. All patients are free from complications or recurrence at a mean follow up of 11.2 months. No patient required a further procedure after BMCP. The bedside modified Clagett procedure is both safe and effective. It is a valuable option in the management of postoperative empyema because it avoids additional operative procedures. This procedure is cost-effective when compared with operative management of perioperative empyema.


Related Articles

  • Modification of the surgical procedure to enable the complete resection of lung cancer with carcinomatous pleuritis. Shimizu, Junzo; Arano, Yoshihiko; Ikeda, Chikako; Adachi, Iwao; Ishikawa, Norihiko; Hirano, Yasumitsu; Minato, Hiroshi // Surgery Today;Sep2010, Vol. 40 Issue 9, p890 

    Carcinomatous pleuritis, accompanied by pleural dissemination or malignant pleural effusion, is listed as one of the factors limiting adequate surgical treatment. It is relatively easy to peel the parietal pleura of the chest wall and mediastinum during a pleuropneumonectomy, but it is quite...

  • Mortality after lung resection: a 15-year analysis of US hospital discharge data. Shaw, Andrew; Swaminathan, Madhav; Phillips-Bute, Barbara; Hailing, Jon; Harpole, David; D'Amico, Thomas; Toloza, Eric; Onaitis, Mark; Stafford-Smith, Mark // Cancer Therapy;2008, Vol. 6 Issue 2, p787 

    Mortality following major surgery is affected by variables relating to the patient, surgeon and disease. We hypothesized that hospital mortality after lung resection surgery would be affected by the number of cases performed each year at a given institution, and by the teaching status of the...

  • Malignes Pleuramesotheliom. Bölükbas, S.; Schirren, J. // Der Chirurg;Jun2013, Vol. 84 Issue 6, p487 

    The role of surgical resection per se and the type of surgery in the management of multimodality treated malignant pleural mesothelioma remains controversial. Patient selection for either extrapleural pneumonectomy or radical pleurectomy depends not only on the cardiopulmonary status of the...

  • LUNG ALERT...........: The role of pneumonectomy in non-tuberculous mycobacterial infections. Price, G. // Thorax;Nov2004, Vol. 59 Issue 11, p954 

    This article presents information about a study which analyzes the role of pneumonectomy in non-tuberculous mycobacterial infections. This study reports over 15 years of experience from the Fukujuji Hospital, Tokyo, reviewing 53 patients who required pulmonary resection for resistant...

  • Recovery Process of Pulmonary Function and Change of Exercise Capacity from Early Influence of Lung Resection. Morisawa, Tomoyuki; Kaneko, Jyunichirou; Suzuki, Akane; Murayama, Fumio; Hiwatari, Masao; Maruyama, Hitoshi // Rigakuryoho Kagaku;2006, Vol. 21 Issue 4, p381 

    The purpose of this study was to reveal the recovery process of pulmonary function from early influence of lung resection and change of exercise capacity before and after the resection, and relating factors of lung function recovery rate. The pulmonary function post-operation was significantly...

  • A case of endobronchial leiomyoma treated by sleeve resection of the right upper lobe bronchus. Koledin, Miloš; Koledin, Bojan; Ilinčić, Dejan; Koledin, Sladjana // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;Feb2016, Vol. 73 Issue 2, p208 

    Introduction. Bronchial leiomyoma is extremely rare. Most reported have been resected by either lobectomy or pneumonectomy. We presented a case treated by sleeve bronchoplasty without pulmonary resection. Case report. The presented case, 39-year-old male, had been admitted to our hospital...

  • Ultrasound in diagnosis, localization, and treatment of loculated pleural empyema. Sandweiss, Donald A.; Hanson, James C.; Gosink, Barbara B.; Moser, Kenneth M.; Sandweiss, D A; Hanson, J C; Gosink, B B; Moser, K M // Annals of Internal Medicine;Jan75, Vol. 82 Issue 1, p50 

    Presents case reports of patients with loculated pleural empyema. Overview of empyema; Diagnostic tests conducted; Treatment given.

  • The intrathoracic vacuum-assisted closure device in case of post-pneumonectomy empyema. Krueger, Thorsten; Perentes, Jean Yannis; Ris, Hans-Beat; Gonzalez, Michel // European Journal of Cardio-Thoracic Surgery;May2013, Vol. 43 Issue 5, p1077 

    A letter to the editor is presented in response to an article related to the post-pneumonectomy empyema, published in previous issue.

  • Sleeve Resections for Squamous Cell Carcinoma of the Lung Gezer, Suat; Öz, Gürhan; Fındık, Göktürk; Türüt, Hasan; Altınok, Tamer; Sırmalı, Mehmet; Gülhan, Erkmen; Ağaçkıran, Yetkin; Kaya, Sadi; Taştepe, İrfan // Heart, Lung & Circulation;Sep2010, Vol. 19 Issue 9, p549 

    Background: Sleeve resection is an advanced technique that was developed as an alternative to pneumonectomy. This study evaluated our cases of sleeve resection for squamous cell carcinoma of the lung and compared the outcomes with the literature reports. Methods: In total, 26 bronchial, 5...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics