NDLI: Treatment of mediastinitis using video-assisted thoracoscopic surgery.

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Treatment of mediastinitis using video-assisted thoracoscopic surgery.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Cho, Jeong Su Kim, Yeong Dae Hoseok, I. Lee, Sang Kwon Jeong, Yeon Joo
Description	Author Affiliation: Cho JS ( National Masan Hospital, Masan, Republic of Korea.)
Abstract	BACKGROUND: Mediastinitis remains a life-threatening disease that is difficult to manage and has a poor prognosis. This is especially true of descending necrotizing mediastinitis, which before the 1990s era had a mortality of approximately 40% despite the use of antibiotics, surgical techniques, and intensive care monitoring. Several authors have recommended that aggressive surgical approaches for mediastinitis are more effective than simple surgical approaches; however the best surgical option for mediastinitis remains controversial. MATERIALS AND METHODS: In a retrospective analysis between January 2000 and June 2006, 17 patients who underwent surgical debridement and drainage using video-assisted thoracoscopic surgery are included in this report. Data extracted from medical records included sex, age, origin of infection, surgical intervention, progress, and outcome including cause of death. There were eight men and nine women. The mean age was 52 years old (range, 20-72). RESULTS: The origins of infection included esophageal perforation in nine patients and odontogenic or peritonsillar abscesses in the remaining eight patients. Among them, two patients required conversion to thoracotomy during operation in cases of mediastinitis due to esophageal perforation, so excluding the two patients, we calculated next five data for 15 patients. The mean duration from onset of symptoms to surgery was 12.4+/-13.1 days (range, 0-43) and the mean duration from the initial operation to discharge was 43.6+/-24.4 days (range, 8-113). There was serial operation in one case. There were three cases of postoperative mortality. CONCLUSION: Mediastinal drainage using video-assisted thoracoscopic surgery with or without cervical drainage can be a feasible and effective surgical option. This less invasive technique seems to have an outcome similar to more aggressive open surgical approaches for patients with mediastinitis previously reported in the literature, although it has not been directly compared.
File Format	HTM / HTML
ISSN	10107940
e-ISSN	1873734X
Journal	European Journal of Cardio-Thoracic Surgery
Issue Number	3
Volume Number	34
Language	English
Publisher	Oxford University Press
Publisher Date	2008-09-01
Publisher Place	Germany
Access Restriction	Open
Subject Keyword	Discipline Cardiology__semicolon__surgery Mediastinitis Surgery Thoracic Surgery, Video-assisted Debridement Drainage Esophageal Perforation Complications Feasibility Studies Etiology Minimally Invasive Surgical Procedures Odontogenic Cysts Peritonsillar Abscess Retrospective Studies Tomography, X-ray Computed Evaluation Studies
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine

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