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The Annals of Thoracic Surgery, Vol 54, 147-149, Copyright © 1992 by The Society of Thoracic Surgeons

ARTICLES

Closure of fenestra in Clagett procedure: use of rectus abdominis musculocutaneous flap

H Asamura, T Goya, T Naruke, R Tsuchiya, H Kondo, K Suemasu and T Nakatsuka
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.

Empyema developed in a 62-year-old man after right pneumonectomy for lung cancer. According to the Clagett procedure, an open window thoracostomy was made with two ribs removed. After 5 weeks, primary closure of the fenestra was attempted. Because the fenestra was too large to be primarily closed, a rectus abdominis musculocutaneous flap was successfully transposed to cover the chest wall. There was no evidence of recurrence of empyema during 11 months' observation after closure. In patients with a large fenestra and with little tissue left for closure, the rectus abdominis musculocutaneous flap could be of great help in completing the Clagett procedure.

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