Successful Use of Intercostal Muscle Flap in Cavitary Lung Lesions


Background: Lung cavities sometimes result from a number of pathological processes including suppurative necrosis, caseous necrosis, ischemic necrosis and cystic dilatation of lung structures. The aim of this study is to evaluate the use of intercostals muscle flap as a successful method to fill the lung cavity for reduction of symptoms and treatment of patients presented with symptomatic pulmonary cavity and to avoid the risk of pulmonary resection. Methods: This is a prospective study conducted between 2009 to 2012, in department of cardiothoracic surgery, Zagazig University Hospital. The study included 32 patients suffering from cavitary lung lesions divided into two groups, group (A): 14 patients treated by using intercostal muscle flap to fill the defect after Cavernostomy without lung resection; and group (B): 18 patients treated by traditional methods by lung resection. Patients with high risk of lung resection, suspicion of dense adhesion, symptomatic chronic lung abscess and patients with bad pulmonary function tests were included in group (A). Results: 20 patients were male and 12 were females in both groups, the large numbers of cases were lung abscess in group A (4 cases 28.5%) followed by Aspergilloma and TB cavity (3 cases 21.4%). Hemoptysis, persistent cough and expectoration were the main presentation of our patients. Poor pulmonary function was significant finding in group A (7 cases 50%). Complications reported in our study were bleeding, recurrent symptoms and one case mortality in group B after Pneuomenectomy. Conclusion: Using the intercostal muscle flap implanted inside the lung cavity after cavernostomy is a successful alternative curative method especially in cases with high risk of lung resection.

Share and Cite:

A. Brik, A. Salem and K. Mostafa, "Successful Use of Intercostal Muscle Flap in Cavitary Lung Lesions," Open Journal of Thoracic Surgery, Vol. 3 No. 1, 2013, pp. 4-7. doi: 10.4236/ojts.2013.31002.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] V. Kumar, A. K. Abbas, N. Fausto, S. L. Robbins and R. S. Cotran, “Robbins and Cotran Pathologic Basis of Disease,” Elsevier Saunders, Philadelphia, 2005.
[2] J. Andreu, J. Cáceres, E. Pallisa and M. M. Rodriguez, “Radiological Manifestations of Pulmonary Tuberculosis,” European Journal of Radiology, Vol. 51, No. 2, 2004, pp. 139-149. doi:10.1016/j.ejrad.2004.03.009
[3] M. Berger and J. R. Thompson, “Cavitary Carcinomatosis of the Lungs,” Chest Journal, Vol. 52, No. 1, 1967, pp. 106-111. doi:10.1378/chest.52.1.106
[4] M. R. Chaudhuri, “Primary Pulmonary Cavitating Carcinomas,” Chest, Vol. 28, No. 3, 1973, pp. 354-366.
[5] J. E. Golub, S. Bur, W. A. Cronin, S. Gange, N. Baruch, G. W. Comstock and R. E. Chaisson, “Delayed Tuberculosis Diagnosis and Tuberculosis Transmission,” International Journal of Tuberculosis and Lung Disease, Vol. 10, No. 1, 2006, pp. 24-30.
[6] A. Brik, A. Salem, A. Kamal, M. Abdel-Sadek, M. Essa, M. El Sharawy, A. Deebes and K. A. Bary, “Surgical Outcome of Pulmonary Aspergilloma,” European Journal Cardio-Thoracic Surgery, Vol. 34, No. 4, 2008, pp. 882-885. doi:10.1016/j.ejcts.2008.06.049
[7] W. K. Moon, J. M. Im, K. M. Yeon and M. C. Han, “Complications of Klebsiella Pneumonia: CT Evaluation,” Journal of Computer Assisted Tomography, Vol. 19, No. 2, 1995, pp. 176-181. doi:10.1097/00004728-199503000-00002
[8] J. M. Hammond, P. D. Potgieter, D. Hanslo, H. Scott and D. Roditi, “The Etiology and Antimicrobial Susceptibility Patterns of Microorganisms in Acute Community-Acquired Lung Abscess,” Chest, Vol. 108, No. 4, 1995, pp. 937-941. doi:10.1378/chest.108.4.937
[9] A. Brik, A. M. Salema, A. Shoukry and W. Shouman, “Surgery for Hemoptysis in Various Pulmonary Tuberculous Lesions: A Prospective Study,” Interactive CardioVasc Thoracic Surgery, Vol. 13, No. 3, 2011, pp. 276-279. doi:10.1510/icvts.2011.270991
[10] M. R. Hallows and D. H. Parikh, “Surgical Management of Children with Pyopneumothorax: Serratus Anterior Digitation Flap,” Journal of Pediatric Surgery, Vol. 39, No. 7, 2004, pp. 1122-1124. doi:10.1016/j.jpedsurg.2004.03.074
[11] I. Jester, A. Nijran, M. Singh and D. H. Parikh, “Surgical Management of Bronchopleural Fistula in Pediatricempyema and Necrotizing Pneumonia: Efficacy of the Serratus Anterior Muscle Digitation Flap,” Journal of Pediatric Surgery, Vol. 47, No. 7, 2012, pp. 1358-1362. doi:10.1016/j.jpedsurg.2011.12.012
[12] M. Takeuchi and H. Sakurai, “Paraspinous Muscle Flap for the Treatment of an Empyema Cavity,” Journal of Plastic, Reconstructive & Aesthetic Surgery, Vol. 65, No. 6, 2012, pp. 824-826.
[13] F. M. Smolle-Juettner, G. Pierer, F. Schwarzl, H. Pinter, B. Ratzenhofer, G. Prause and G. Friehs, “Life-Saving Muscle Flaps in Tracheobronchial Dehiscence Following Resection or Trauma,” European Journal Cardio-Thoracic Surgery, Vol. 12, No. 3, 1997, pp. 351-355. doi:10.1016/S1010-7940(97)00180-2

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.