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Tomoyuki Goya
Tsuguo Naruke
Ryosuke Tsuchiya
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Ann Thorac Surg 1992;54:147-149
© 1992 The Society of Thoracic Surgeons


Articles

Closure of fenestra in clagett procedure: Use of rectus abdominis musculocutaneous flap

Hisao Asamura, MD*, Tomoyuki Goya, MD, Tsuguo Naruke, MD, Ryosuke Tsuchiya, MD, Haruhiko Kondo, MD, Keiichi Suemasu, MD, Takashi Nakatsuka, MD

Divisions of Thoracic Surgery and Plastic and Reconstructive Surgery, Department of Surgery, National Cancer Center Hospital, Tokyo, Japan

Accepted for publication October 14, 1991.

* Address reprint requests to Dr Asamura, Division of Thoracic Surgery, Department of Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104, 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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