Vytautas Jovaišas, Algis Kybartas, Jonas Narbutas, Arūnas Žilinskas, Ričardas Janilionis

Vilnius University Hospital “Red Cross” Department of General Thoracic Surgery

Key words: Eloesser open flap procedure, pleural empyema, pyopneumothorax, open thoracostomy.

Summary. Eloesser open flap procedure or open thoracostomy is performed for management of patients with various origin pleural empyemas. After unsuccessful treatment by tube thoracostomy, infection has a great opportunity to involve chest wall. This method of management very useful in debilitated patients, in whom more radical approach is impossible.

During 9-year period (1992–2000) open thoracostomy was performed in 189 patients with empyema or pyopneumothorax. The main causes of empyema where as follows: necrotic pneumonia – 115 (61%), postresectional complications – 33 (17.4%), metapneumonic empyema – 13 (7.1%). Most often two ribs had been resected during the procedure, however in some cases, one or more than two ribs where resected. 56 (29%) patients died posoperatively. Second step operations undergo 16 (13%) survivors. Myoplasty – 14, lung resection – 2.

In conclusion, Eloesser open flap procedure is useful in a life threatening situations. When patient’s general condition becomes better, second step operation is possible.