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Neumología y cirugía de tórax

versión impresa ISSN 0028-3746

Resumen

WALDO-HERNANDEZ, Luis Iván; RUEDA-VILLALPANDO, José Pablo; CRUZ-LOPEZ, Marco Antonio  y  VAZQUEZ-MINERO, Juan Carlos. Descending necrotizing mediastinitis. A 16 years experience from a referral center. Neumol. cir. torax [online]. 2022, vol.81, n.3, pp.172-177.  Epub 08-Dic-2023. ISSN 0028-3746.  https://doi.org/10.35366/111087.

Introduction:

descending necrotizing mediastinitis (DNM) refers to mediastinal infections originating in the oropharyngeal and cervicofacial region that spread through the deep planes of the cervical fascia into the mediastinum. Multiple organ failure and high mortality are related to the delay in diagnosis and medical-surgical treatment. Surgical treatment remains controversial, with supports ranging from isolated cervical drainage to cervical drainage and thoracotomy and/or median sternotomy.

Objective:

to know the morbidity and mortality related to the surgical management of NDM as well as the main etiology prevalent in our environment.

Material and methods:

it is a retrospective study in a period between 2006 and 2022 of patients with MND who were hospitalized and surgically treated in the Thoracic Surgery Service of the National Institute of Respiratory Diseases Ismael Cosío Villegas.

Results:

51 patients were included, 38 men, age 39.19 ± 14.06 years. 41 patients were classified ENDO IIB, 9 ENDO I, the main cause was odontogenic in 28 patients. Days of hospital stay of 22.65 ± 15.61 days. 12 patients operated by cervicotomy and 39 patients combined approach. 22 patients required reintervention. 14 deaths, the most prevalent cause of septic shock.

Conclusions:

the approaches used according to the availability of resources over time and hospital stay and mortality do not differ from what is reported in the literature.

Palabras llave : mediastinitis; abscess; sternotomy; cervicotomy; thoracoscopy.

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