OPEN WINDOW THORACOSTOMY FOR MULTIPLE LUNG ABCESS
DOI:
https://doi.org/10.31004/prepotif.v9i1.42785Keywords:
Open Window Thoracostomy, Multiple Lung Abscess, Surgical Management, Post-Operative Care, Pulmonary InfectionAbstract
Abses paru multipel tetap menjadi tantangan signifikan dalam pengobatan paru, terutama pada kasus yang resistan terhadap terapi konvensional. Penanganan kasus kompleks ini memerlukan pendekatan bedah yang tepat, dengan Open Window Thoracostomy (OWT) muncul sebagai opsi potensial untuk kasus yang sulit. Untuk melaporkan keberhasilan penanganan abses paru multipel menggunakan teknik OWT dengan komorbid diabetes melitus dan riwayat konsumsi alkohol kronis. Seorang pria dengan diabetes melitus tipe 2 yang tidak terkontrol dengan baik (HbA1c 9,2%) datang dengan batuk produktif, demam, dan dispnea progresif selama tiga minggu. CT scan dada menunjukkan tiga rongga abses di paru kanan dengan berbagai ukuran (6,8 x 5,2 cm, 4,5 x 3,8 cm, dan 5,6 x 4,7 cm). Setelah kegagalan terapi antibiotik selama 14 hari, prosedur OWT dilakukan menggunakan pendekatan anterolateral yang dimodifikasi. Pemulihan pascaoperasi mencakup protokol perawatan luka terstruktur dan rehabilitasi komprehensif. Penutupan luka yang lengkap dicapai pada bulan ke-4, dengan perbaikan signifikan pada fungsi paru (FEV1 82% dan FVC 78% dari nilai prediksi) pada bulan ke-6 pascaoperasi. OWT terbukti efektif dalam mengelola abses paru multipel yang kompleks, bahkan pada pasien dengan komorbiditas yang signifikan. Rekomendasi mencakup pentingnya pengenalan dini kegagalan pengobatan medis, optimalisasi teknik bedah dengan rekonstruksi CT 3D, pengembangan protokol pascaoperasi yang terstruktur, dan perlunya penelitian lebih lanjut tentang faktor prediktif untuk keberhasilan OWT.References
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