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4 results on '"Passera E"'

1. Caveats in using vacuum-assisted closure for post-pneumonectomy empyema.

Author

Rocco G, Cecere C, La Rocca A, Martucci N, Salvi R, Passera E, and Cicalese M

Subjects
Bronchial Fistula etiology, Bronchial Fistula surgery, Empyema, Pleural etiology, Humans, Hypotension etiology, Lung Neoplasms surgery, Male, Middle Aged, Negative-Pressure Wound Therapy adverse effects, Negative-Pressure Wound Therapy instrumentation, Outpatient Clinics, Hospital, Pleural Diseases etiology, Pleural Diseases surgery, Postoperative Care methods, Respiratory Tract Fistula etiology, Respiratory Tract Fistula surgery, Surgical Sponges, Thoracoscopy, Empyema, Pleural surgery, Negative-Pressure Wound Therapy methods, Pneumonectomy adverse effects
Abstract

Objectives: Vacuum-assisted closure (VAC) of chronic empyemas can potentially set challenging patients free of prolonged hospitalization by warranting outpatient care. We wanted to test this concept in post-pneumonectomy empyema patients., Methods: Three patients with post-pneumonectomy bronchopleural fistula were subjected to open window thoracostomy (OWT) and subsequently to VAC. The BPFs were closed by endobronchial stents in 2 of the patients. The VAC system was applied at a median time of 35 days (range, 23-113) after pneumonectomy. The patients were scheduled for outpatient visits every three days with complete change of the VAC sponges., Results: Hypotension and acute thoracic pain despite minimal suction applied to the VAC sponges were observed during treatment and eventually caused VAC discontinuation. In one patient, the sponges of the VAC system could not be directly removed through the OWT and careful dissection through VATS under deep sedation was needed., Conclusions: VAC can be of help to obliterate the post-pneumonectomy empyema cavity but its use can trigger clinically significant complications. Cautious monitoring of the VAC system must be exercised in the early period prior to discharging patients to the outpatient clinic.

Published
2012
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2. Amplatzer device and vacuum-assisted closure therapy to treat a thoracic empyema with bronchopleural fistula.

Author

Passera E, Guanella G, Meroni A, Chiesa G, Rizzi A, and Rocco G

Subjects
Adenocarcinoma pathology, Adenocarcinoma surgery, Aged, Bronchoscopy, Debridement methods, Humans, Image Processing, Computer-Assisted, Imaging, Three-Dimensional, Lung Neoplasms pathology, Lung Neoplasms surgery, Male, Neoplasm Staging, Tomography, X-Ray Computed, Bronchial Fistula surgery, Empyema, Pleural surgery, Fistula surgery, Methicillin-Resistant Staphylococcus aureus, Negative-Pressure Wound Therapy, Pleural Diseases surgery, Pneumonectomy, Postoperative Complications surgery, Septal Occluder Device, Staphylococcal Infections surgery, Thoracic Surgery, Video-Assisted methods, Thoracostomy methods
Abstract

We present a case of lower bilobectomy complicated by a large bronchopleural fistula and empyema 1 month after primary surgery. The patient was immediately treated with an open window thoracostomy. After surgical debridement, an Amplatzer Septal Occluder device (AGA Medical Corp, Plymouth, MN) was positioned to close the fistula. Thereafter, the thoracostomy rapidly and spontaneously closed with vacuum-assisted closure therapy., (Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Published
2011
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3. Uniportal VATS wedge pulmonary resections.

Author

Rocco G, Martin-Ucar A, and Passera E

Subjects
Alveolitis, Extrinsic Allergic pathology, Alveolitis, Extrinsic Allergic surgery, Biopsy methods, Diagnosis, Differential, Feasibility Studies, Female, Humans, Lung pathology, Lung Diseases, Interstitial pathology, Male, Middle Aged, Pleura pathology, Pleura surgery, Pneumothorax pathology, Pulmonary Fibrosis pathology, Pulmonary Fibrosis surgery, Sarcoidosis pathology, Sarcoidosis surgery, Lung Diseases, Interstitial surgery, Pneumonectomy methods, Pneumothorax surgery, Thoracic Surgery, Video-Assisted methods
Abstract

Since 2000, 15 patients have undergone single port (uniportal) video-assisted thoracic surgery for wedge pulmonary resection either for diagnosis of interstitial lung diseases (10 patients) or for treatment of primary spontaneous pneumothoraces (5 patients). Diagnosis was obtained in all patients and no recurrences of pneumothorax were seen at follow-up. This initial experience shows that, for specific indications, uniportal video-assisted thoracic surgery for wedge pulmonary resections can be safe and effective.

Published
2004
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4. Caveats in using vacuum-assisted closure for post-pneumonectomy empyema

Author

Rosario Salvi, Marcellino Cicalese, Nicola Martucci, Cecere C, Gaetano Rocco, Eliseo Passera, Antonello La Rocca, Rocco, G, Cecere, Ciriaco, La Rocca, A, Martucci, N, Salvi, R, Passera, E, and Cicalese, M.

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Surgical Sponges, Bronchopleural fistula, General Medicine, medicine.disease, Thoracostomy, Empyema, Surgery, Pneumonectomy, Anesthesia, Negative-pressure wound therapy, Thoracoscopy, medicine, Outpatient clinic, Cardiology and Cardiovascular Medicine, business
Abstract

OBJECTIVES: Vacuum-assisted closure (VAC) of chronic empyemas can potentially set challenging patients free of prolonged hospitalization by warranting outpatient care. We wanted to test this concept in post-pneumonectomy empyema patients. METHODS: Three patients with post-pneumonectomy bronchopleural fistula were subjected to open window thoracostomy (OWT) and subsequently to VAC. The BPFs were closed by endobronchial stents in 2 of the patients. The VAC system was applied at a median time of 35 days (range, 23–113) after pneumonectomy. The patients were scheduled for outpatient visits every three days with complete change of the VAC sponges. RESULTS: Hypotension and acute thoracic pain despite minimal suction applied to the VAC sponges were observed during treatment and eventually caused VAC discontinuation. In one patient, the sponges of the VAC system could not be directly removed through the OWT and careful dissection through VATS under deep sedation was needed. CONCLUSIONS: VAC can be of help to obliterate the post-pneumonectomy empyema cavity but its use can trigger clinically significant complications. Cautious monitoring of the VAC system must be exercised in the early period prior to discharging patients to the outpatient clinic.

Published
2011

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