UNSUCCESSFUL OMENTOPEXY IN THORACIC-SURGERY

Omentopexy has improved the treatment of chronic empyema and postpneum onectomy bronchopleural fistula, which otherwise are difficult to mana ge. However, omentopexy is not effective in some patients. Four of 17 patients who underwent omentopexy in our institution between January 1 978 and March 1994 did not respond to the treatment and died. In two p atients, a dead space remained after surgery and there was insufficien t sterilization. in one patient, a dead space appeared after surgery a nd it was impossible to control infection. The fourth patient had dehi scence of the anastomosis triggered by postoperative acute gastritis. All four patients in whom omentopexy was not successful died. When ome ntopexy is used for empyema, the space should first be sterilized. If sterilization is insufficient, muscle filling and thoracoplasty must b e performed and no dead space left.