Re-operation through the same approach after thoracic surgery excepting postoperative clotted hemothorax: retrospective study about 20 patients

Abstract

In thoracic surgery, postoperative clotted hemothorax presents the frequent complication indication reoperation of patients. Operate through the same incision especially after thoracotomy needs a laborious pulmonary release. We included 20 patients who were operated for a second time through the same incision. We excluded from this study patients reoperated for postoperative clotted hemothorax. It was 9 men (45%) and 11 women (55%). The median age was 50.55 years old. Nine patients (45%) were operated firstly outside our department, against 11 patients (55%). Duration between the first and second surgery was varied from 4 days to 30 years. The etiologies indicating the first surgery were especially hydatidosis in 7 patients (35%), chest wall disease in 3 patients (15%), post-trauma affections in 2 patients (10%), mediastinal pathology in 2 patients (10%). The approach for the first intervention were thoracotomy in 12 patients (60%), elective incision in 3 patients (15%), cervicotomy in 2 patients (10%), sternotomy in 1 patient (5%), mediastinoscopy in 1 patient (5%) and anterior mediastinotomy in 1 patient (5%). The reasons why a re-operation was indicated were essentially: recurrence of hydatidosis in 3 patients (15%), inconclusive anatomopathological study in 2 patients (10%), fortuitous adenorcacinoma discovery in 2 patients (10%), postoperative empyema in 4 patients (20%) and infection of the chest wall in 3 patients (15%). The rate of mortality was 15% in 3 patients. Reoperation through the same incision especially after thoracotomy is accompanied with a difficult pulmonary release. Among the indications responsible of reoperation, we quote recurrence of the primary disease, an inconclusive anatomopathological study and fortuitous discovery of lung cancer.

Keywords

• reoperation
• thoracic surgery
• rethoracotomy