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J M Wihlm - One of the best experts on this subject based on the ideXlab platform.

  • long term complications of extraperiosteal plombage
    The Annals of Thoracic Surgery, 1997
    Co-Authors: Gilbert Massard, Pierre Barsotti, Pierre Riera, E Reboud, Georges Morand, Roger Giudicelli, Pierre Fuentes, P. Thomas, J M Wihlm
    Abstract:

    Abstract Background . As soon as complications due to migration of extraperiosteal plombage material had been documented, early removal became the rule. Some patients who have escaped this rule may still present with long-term complications. Methods . Since 1980, 14 patients aged 54 ± 10 years were admitted 28 ± 11 years after Collapse Therapy. Eight presented with signs of infection, 4 with hemoptysis, and 2 with periscapular pain. Vascular erosion, suspected in 3 patients, was demonstrated with angiograms in 1. Results . Ablation of the material was combined with excision of the devitalized ribs in 13 patients. Femorofemoral bypass was used in 2 patients for repair of an aortic erosion. Single ablation of subcutaneously migrated material was performed in a poor-risk patient. Operative bleeding was moderate except in 2 patients; 1 of them died intraoperatively during repair of an aortic erosion. A second patient died postoperatively with a massive pulmonary embolus on day 11. Infection was diagnosed in 8 patients ( Mycobacterium tuberculosis , 4; and pyogens, 4). Operative outcome was satisfactory in all 12 operative survivors. A single patient presented with an infected apical space at 1 year and underwent complementary resection of the first rib. Conclusions . We recommend routine ablation of any residual plombage material whenever operative risk is acceptable because of the high incidence of spontaneous complications.

  • long term complications of extraperiosteal plombage
    The Annals of Thoracic Surgery, 1997
    Co-Authors: Gilbert Massard, Pierre Barsotti, Pierre Riera, E Reboud, Georges Morand, Roger Giudicelli, Pierre Fuentes, P. Thomas, J M Wihlm
    Abstract:

    Abstract Background . As soon as complications due to migration of extraperiosteal plombage material had been documented, early removal became the rule. Some patients who have escaped this rule may still present with long-term complications. Methods . Since 1980, 14 patients aged 54 ± 10 years were admitted 28 ± 11 years after Collapse Therapy. Eight presented with signs of infection, 4 with hemoptysis, and 2 with periscapular pain. Vascular erosion, suspected in 3 patients, was demonstrated with angiograms in 1. Results . Ablation of the material was combined with excision of the devitalized ribs in 13 patients. Femorofemoral bypass was used in 2 patients for repair of an aortic erosion. Single ablation of subcutaneously migrated material was performed in a poor-risk patient. Operative bleeding was moderate except in 2 patients; 1 of them died intraoperatively during repair of an aortic erosion. A second patient died postoperatively with a massive pulmonary embolus on day 11. Infection was diagnosed in 8 patients ( Mycobacterium tuberculosis , 4; and pyogens, 4). Operative outcome was satisfactory in all 12 operative survivors. A single patient presented with an infected apical space at 1 year and underwent complementary resection of the first rib. Conclusions . We recommend routine ablation of any residual plombage material whenever operative risk is acceptable because of the high incidence of spontaneous complications.

Peter Goldstraw - One of the best experts on this subject based on the ideXlab platform.

  • plombage thoracoplasty with lucite balls
    The Annals of Thoracic Surgery, 2005
    Co-Authors: Cagatay Saim Tezel, Peter Goldstraw
    Abstract:

    An 82-year-old male nonsmoker presented with hemoptysis. He had had a history of pulmonary tuberculosis in 1948 and underwent repeated artificial pneumothorax, pneumoperitoneum, and phrenic nerve crush, followed by extrapleural plombage with polymerized methyl methacrylate (Lucite) balls at the Royal Brompton Hospital. Chest radiograph (Fig 1) shows a number of Lucite balls surrounded by some scar tissue. Computer tomographic scan (Fig 2) of the thorax showed Lucite balls at the right apex. Air can be seen outside the balls, which suggests a communication between the plomb and lung parenchyma. This usually results in infection in the plomb. Bronchoscopy showed partial obstruction of the apical segment of the right lower lobe by granulation tissue with no evidence of malignancy. In this age group, further surgical treatment such as removal of the plombage material, prolonged drainage followed by softtissue transfer is a major undertaking. The patients’ symptoms were not severe and he was content to be followed up without treatment for the present. Plombage, a variant of Collapse Therapy that uses a variety of foreign materials, including Lucite balls (Fig 3), was undertaken in the late 1940s and ended in the 1950s. In the long term these can erode into the lung parenchyma, allowing infection to enter the plombage space. Eradication requires removal of the plomb and softtissue transfer or thoracoplasty to obliterate the space. Address reprint requests to Dr Tezel, Department of Thoracic Surgery, Royal Brompton Hospital, Sydney St, London SW3 6NP, UK; e-mail: mdcagatay@hotmail.com. Fig 1. Fig 2.

Gil Weisbrod - One of the best experts on this subject based on the ideXlab platform.

Gilbert Massard - One of the best experts on this subject based on the ideXlab platform.

  • long term complications of extraperiosteal plombage
    The Annals of Thoracic Surgery, 1997
    Co-Authors: Gilbert Massard, Pierre Barsotti, Pierre Riera, E Reboud, Georges Morand, Roger Giudicelli, Pierre Fuentes, P. Thomas, J M Wihlm
    Abstract:

    Abstract Background . As soon as complications due to migration of extraperiosteal plombage material had been documented, early removal became the rule. Some patients who have escaped this rule may still present with long-term complications. Methods . Since 1980, 14 patients aged 54 ± 10 years were admitted 28 ± 11 years after Collapse Therapy. Eight presented with signs of infection, 4 with hemoptysis, and 2 with periscapular pain. Vascular erosion, suspected in 3 patients, was demonstrated with angiograms in 1. Results . Ablation of the material was combined with excision of the devitalized ribs in 13 patients. Femorofemoral bypass was used in 2 patients for repair of an aortic erosion. Single ablation of subcutaneously migrated material was performed in a poor-risk patient. Operative bleeding was moderate except in 2 patients; 1 of them died intraoperatively during repair of an aortic erosion. A second patient died postoperatively with a massive pulmonary embolus on day 11. Infection was diagnosed in 8 patients ( Mycobacterium tuberculosis , 4; and pyogens, 4). Operative outcome was satisfactory in all 12 operative survivors. A single patient presented with an infected apical space at 1 year and underwent complementary resection of the first rib. Conclusions . We recommend routine ablation of any residual plombage material whenever operative risk is acceptable because of the high incidence of spontaneous complications.

  • long term complications of extraperiosteal plombage
    The Annals of Thoracic Surgery, 1997
    Co-Authors: Gilbert Massard, Pierre Barsotti, Pierre Riera, E Reboud, Georges Morand, Roger Giudicelli, Pierre Fuentes, P. Thomas, J M Wihlm
    Abstract:

    Abstract Background . As soon as complications due to migration of extraperiosteal plombage material had been documented, early removal became the rule. Some patients who have escaped this rule may still present with long-term complications. Methods . Since 1980, 14 patients aged 54 ± 10 years were admitted 28 ± 11 years after Collapse Therapy. Eight presented with signs of infection, 4 with hemoptysis, and 2 with periscapular pain. Vascular erosion, suspected in 3 patients, was demonstrated with angiograms in 1. Results . Ablation of the material was combined with excision of the devitalized ribs in 13 patients. Femorofemoral bypass was used in 2 patients for repair of an aortic erosion. Single ablation of subcutaneously migrated material was performed in a poor-risk patient. Operative bleeding was moderate except in 2 patients; 1 of them died intraoperatively during repair of an aortic erosion. A second patient died postoperatively with a massive pulmonary embolus on day 11. Infection was diagnosed in 8 patients ( Mycobacterium tuberculosis , 4; and pyogens, 4). Operative outcome was satisfactory in all 12 operative survivors. A single patient presented with an infected apical space at 1 year and underwent complementary resection of the first rib. Conclusions . We recommend routine ablation of any residual plombage material whenever operative risk is acceptable because of the high incidence of spontaneous complications.

Cagatay Saim Tezel - One of the best experts on this subject based on the ideXlab platform.

  • plombage thoracoplasty with lucite balls
    The Annals of Thoracic Surgery, 2005
    Co-Authors: Cagatay Saim Tezel, Peter Goldstraw
    Abstract:

    An 82-year-old male nonsmoker presented with hemoptysis. He had had a history of pulmonary tuberculosis in 1948 and underwent repeated artificial pneumothorax, pneumoperitoneum, and phrenic nerve crush, followed by extrapleural plombage with polymerized methyl methacrylate (Lucite) balls at the Royal Brompton Hospital. Chest radiograph (Fig 1) shows a number of Lucite balls surrounded by some scar tissue. Computer tomographic scan (Fig 2) of the thorax showed Lucite balls at the right apex. Air can be seen outside the balls, which suggests a communication between the plomb and lung parenchyma. This usually results in infection in the plomb. Bronchoscopy showed partial obstruction of the apical segment of the right lower lobe by granulation tissue with no evidence of malignancy. In this age group, further surgical treatment such as removal of the plombage material, prolonged drainage followed by softtissue transfer is a major undertaking. The patients’ symptoms were not severe and he was content to be followed up without treatment for the present. Plombage, a variant of Collapse Therapy that uses a variety of foreign materials, including Lucite balls (Fig 3), was undertaken in the late 1940s and ended in the 1950s. In the long term these can erode into the lung parenchyma, allowing infection to enter the plombage space. Eradication requires removal of the plomb and softtissue transfer or thoracoplasty to obliterate the space. Address reprint requests to Dr Tezel, Department of Thoracic Surgery, Royal Brompton Hospital, Sydney St, London SW3 6NP, UK; e-mail: mdcagatay@hotmail.com. Fig 1. Fig 2.