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Acute Mediastinitis


Authors: T. Bohanes;  Č. Neoral
Authors‘ workplace: I. chirurgická klinika LF UP a FN Olomouc, přednosta: doc. MUDr. Čestmír Neoral, CSc.
Published in: Rozhl. Chir., 2011, roč. 90, č. 11, s. 604-611.
Category: Monothematic special - Original

Overview

The authors give an outline of the issue of acute mediastinitis. It is a severe infection of connective tissue of the mediastinum. Timing of recognition and accuracy of drainage are the most essential conditions of successful treatment. Acute mediastinitis may be divided in the postoperative sternal infections with infection of the mediastinum, mediastinitis due to perforation of the aero-digestive tract and descending necrotizing mediastinitis. The authors describe etiopathogenesis, diagnostics and therapy in each particular type of mediastinitis.

Key words:
mediastinitis – infection – perforation – esofagus – thoracic surgery – drainage – stent


Sources

1. Liptay, M. J., Kim, A. W. Acute and chronic mediastinal infections. In: Shields, T. W, Locicero III, J., Reed, C. E., Feins, R. H., eds.: General thoracic surgery. 7th edition. Philadelphia, Lippincott Williams &Wilkins, 2009: 2181–2186.

2. El Oakley, R. M., Wright, J. E. Postoperative mediastinitis: classification and management. Ann. Thorac. Surg., 1996;61 (3):1030–1036.

3. Sá, M. P., Silva, D. O., Lima, E. N. de S., et al. Postoperative mediastinitis in cardiovascular surgery. Analysis of 1038 consecutive surgeries. Čas. Rev. Bras. Cir. Cardiovasc., 2010; 25(1): 19–24.

4. Tarelli, G., Maugeri, R., Pedretti, R., et al. The use of bilateral mammary artery in myocardial revascularization. The risc factors emergent from multivariate analysis conducted on 474 patients. G. Ital. Cardiol., 1998; 28 (11): 1230–1237.

5. Francel, T. J., Kouchoukos, N. T. A rational approach to wound difficulties after sternotomy: the problem. Ann. Thorac. Surg., 2001; 72 (4): 1411–1429.

6. Karra, R., McDermott, L., Connelly, S., et al. Risk factors for 1-year letality after postoperative mediastinitis. J. Thorac. Cardiovasc. Surg., 2006; 132 (3): 537–543.

7. Milano, C. A., Georgiade, G., Muhlbaier, L. H., Smith, P. K., Wolfe, W. G. Comparison of omental and pectoralis flap for poststernotomy mediastinitis. Ann. Thorac. Surg., 1999; 67 (2): 377–380.

8. Argenta, L. C., Morykwas, M. J. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann. Plast. Surg., 1997; 38 (6): 563–576.

9. Obdeijn, M. C., de Lange, M. Y., Lichtendahl, D. H., de Boer, W. J. Vacuum-assisted closure in the treatment of poststernotomy mediastinitis. Ann. Thorac. Surg., 1999; 68 (6): 2358–2560.

10. Fuchs, U., Zittermann, A., Stüttgen, B., et al. Clinical outcome of patients with deep sternal wound infection managed by vacuum-assisted closure compared to conventional therapy with open packing: a retrospective analysis. Ann. Thorac. Surg., 2005; 79 (2): 526–531.

11. Brinster, C. J., Singhal, S., Lee, L., et al. Evolving option in the management of esophageal perforation. Ann. Thorac. Surg., 2004; 77: 1475–1483.

12. Guitron, J., Howington, J. A., LoCicero III, J. Esophageal trauma. In: Shields, T. W, Locicero III, J., Reed, C. E., Feins, R. H., eds.: General thoracic surgery. 7th edition. Philadelphia, Lippincott Williams &Wilkins, 2009: 1851–1865.

13. Barrett, N. R. Report of a case of spontaneous perforation of the esophagus successfully treated by operation. Br. J. Surg., 1947; 35: 216.

14. Mallory, G. K., Weiss, S. Hemorrhage from lacerations of the cardiac orifice of the stomach due to vomiting. Am. J. Med. Sci., 1929; 178: 506.

15. Onat, S., Ulku, R., Cigdem, K. M., et al. Factor affecting the outcome of surgically treated non-iatrogenic traumatic cervical esophageal perforation: 28 years experience at a single centre. J. Cardiothorac. Surg., 2010; 5: 46.

16. Schmidt, S. C., Strauch, S., Rösch, T. Management of esophageal perforations. Surg. Endosc., 2010; 24 (11): 2809–2813.

17. Černá, M., Köcher, M., Válek, V., et al. Covered biodegradable stent: New therapeutic option for management of esophageal perforation or anastomotic leak. Cardiovasc. Intervent. Radiol., 2011, epub 7. 1. 2011.

18. Mayer, J. E. Jr., Murray, C. A., Varco, R. L. The treatment of esophageal perforation with delayed recognition and continuing sepsis. Ann. Thorac. Surg., 1977; 23 (6): 586–573.

19. Jougon, J., Mc Bride, T., Delcambre, F., Minniti, A., Velly, J. F. Primary esophageal repair for Boerhaave’s syndrome whatever the free interval between perforation and treatment. Eur. J. Cardiothorac. Surg., 2004; 25: 475–479.

20. Scott, H. J., Rosin, R. D. Thoracoscopic repair of a transmural rupture of the esophagus (Boerhaave’s syndrome). J. R. Soc. Med., 1995; 88: 414P–415P.

21. Eloubeidi, M. A., Lopes, T. L. Novel removable internally fully covered self-expanding metal esophageal stent: feasibility, technique of removal and tissue response in humans. Am. J. Gastroenterol., 2009; 104: 1374–1381.

22. Salminen, P., Gullichsen, R., Laine, S. Use of self-expandable metal stents for the treatment of esophageal perforations and anastomotic leaks. Surg. Endosc., 2009; 23: 1526–1530.

23. Leers, J. M., Vivaldi, C., Schafer, H., et al. Endoscopic therapy for esophageal perforation or anastomotic leak with a self-expandable metallic stent. Surg. Endosc., 2009; 23: 2258–2262.

24. Fry, S. W., Fleischer, D. E. Management of a refractory benign esophageal stricture with a new biodegradable stent. Gastrointest. Endosc., 1997; 45: 179–182.

25. Estrera, A. S., Landay, M. J., Grisham, J. M., Sinn, D. P., Platt, M. R. Descending necrotizing mediastinitis. Surg. Gynecol. Obstet., 1983; 157 (6): 545–552.

26. Min, H. K, Choi, Y. S., Shim, Y. M., Sohn, Y. I., Kim, J. Descending necrotizing mediastinitis: a minimally invasive approach using video-assisted surgery. Ann. Thorac. Surg., 2004; 77: 306–310.

27. Mathieu, D., Neviere, R., Teillon, C., Chagnon, J. L., Lebleu, N., Wattel, F. Cervical necrotizing fasciitis: clinical manifestations and management . Clin. Infect. Dis., 1995; 21: 51–56.

28. Sandner, A., Börgermann, J. Update on necrotizing mediastinitis: Causes, approaches to management, and outcomes. Curr. Infect. Dis. Rep., 2011; 13: 278–286.

29. Wolf, H., Ovesen, T. Necrotizing fasciitis in the head and neck region. Ugeskr. Laeger., 2008; 170: 2563–2566.

30. Carrol, C. L., Jeffrey, R. B. Jr., Federle, M. P., Vernacchia, F. S. CT evaluation of mediastinal infections. J. Comput. Assist. Tomogr., 1987; 11: 449–454.

31. Endo, S. M., Hasegawa, T., Yamamoto, S., et al. Guidline of surgical management based od diffusion of descending necrotizing mediastinitis. Jpn. Thorac. Cardiovasc. Surg., 1999; 47 (1): 14–19.

32. Hsu, R. F., Wu, P. Y., Ho, C. K. Transcervical drainage for descending necrotizing mediastinitis may be sufficient. Otorynolaryngol. Head Neck Surg., 2011, epub 26. 4. 2011.

33. Shimizu, K., Otani, Y., Nakano, T., et al. Successful video-assisted mediastinoscopic drainage of descending necrotizing mediastinitis. Ann. Thorac. Surg., 2006; 81: 2279–2281.

34. Karkas, A., Chahine, K., Schmerber, S., Brichon, P. Y., Righini, C. A. Optimal treatment of cervical necritizing fasciitis associated with descending necrotizing mediastinitis. Br. J. Surg., 2010; 97: 609–615.

35. Klečka, J., Šimánek, V., Vodička, J., Špidlen, V., Pradl, R., Ferda, J. Akutní mediastinitis – optimální diagnostická a léčebná opatření. Rozhl. Chir., 2009; 88 (5): 253–258.

36. Bains, M. S, Ginsberg, R. J., Jones, W. D. II., et al. The clamshell incision: An improvement approach to bilateral pulmonary and mediastinal tumor. Ann. Thorac. Surg., 1994; 58: 30–33.

37. Ris, H. B., Banic, A., Furrer, M., Caversaccio, M., Cerny, A., Zbären, P. Descending necrotizing mediastinitis surgical treatment via clamshell approach. Ann. Thorac. Surg., 1996; 62: 1650–1654.

38. Roberts, J. R., Smythe, W. R., Weber, R. W., Lanutti, M., Rosengard, B. R., Kaiser, L. R. Thoracoscopic management of descending necrotizing mediastinitis. Chest, 1997; 112: 850–854.

39. Watanabe, S., Kariatsumari, K., Sakasegawa, K., et al. A new combined surgical procedure for severe descending necrotizing mediastinitis with bilateral empyema. Thorac. Cardiovasc. Surg., 2002; 50: 380–310.

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