Myoplasty with the Latissimus Dorsi Muscle for Surgical Site Infection and Pleural Empyema after Resection of a Pulmonary Superior Sulcus Tumor Using the Transmanubrial Approach

Abstract

The transmanubrial approach is a standard operative procedure for Pancoast tumors, but few reports on the complications with the procedure have been described. We report a case of a patient with a superior sulcus tumor, who developed postoperative surgical site infection and pleural empyema, which were successfully treated by myoplasty. A 78-year-old male patient underwent the resection of a superior sulcus tumor in the right upper lobe (squamous cell carcinoma) with the involved chest wall and brachiocephalic vein, using the transmanubrial approach after chemoradiotherapy. Ten days after the surgery, he developed postoperative surgical site infection and pleural empyema, and underwent a second operation. After debridement and washing of the thoracic cavity and mediastinum, a right latissimus dorsi muscle flap was harvested and intrathoracic transposition was performed to fill the upper section of the right thorax and to cover the mediastinal and cervical structures. There has been no evidence of recurrence of either the tumor or the infection over the two years and four months since this operation.