HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gossot, D. Articles by Grunenwald, D. Search for Related Content PubMed PubMed Citation Articles by Gossot, D. Articles by Grunenwald, D. Related Collections Pleura

Ann Thorac Surg 2004;78:273-276
© 2004 The Society of Thoracic Surgeons

---

Original article: general thoracic

Thoracoscopic management of postpneumonectomy empyema

^a Thoracic Department, Institut Mutualiste Montsouris, Paris, France

Accepted for publication February 6, 2004.

^* Address reprint requests to Dr Gossot, Thoracic Department, Institut Mutualiste Montsouris, 42 Bd Jourdan, F-75014 Paris, France
e-mail: dominique.gossot{at}imm.fr

BACKGROUND: Even when there is no associated bronchopleural fistula, empyema is a serious complication of pneumonectomy. Aggressive surgical treatments are usually applied. However, a minimally invasive approach might achieve satisfactory results in selected patients.

METHODS: Out of 17 patients presenting with a postpneumonectomy empyema (PPE), 11 had a thoracoscopic approach. There were 9 males and 2 females, (age, 38–74; mean, 59 years). Ten patients had no proven bronchopleural fistula (BPF). One of them had a minor (< 3 mm) BPF. Empyema was confirmed by thoracentesis and bacteriological examination. All patients had immediate chest tube drainage and underwent emergency thoracoscopic debridement of the empyema. No irrigation was used postoperatively.

RESULTS: There was no mortality and no morbidity related to the procedure. The average duration of thoracoscopic debridement was 62 minutes (range: 45–80 minutes). In 8 patients the chest tube was removed between the fifth and thirteenth postoperative day (average, 8.6 days). They were discharged between the 9th and 24th postoperative day. In 3 patients, clinical and/or biological signs of infection persisted and reoperation was decided at day 5, day 10, and day 11. All 3 patients underwent open-window thoracostomy. The average follow-up of the 8 patients who underwent only thoracoscopy was 10 months (range, 2–27 months). None had recurrent empyema. The patient who presented with a minor BPF remained asymptomatic and is doing well after a 27 month follow-up.

CONCLUSIONS: Thoracoscopy might be a valuable approach for patients presenting with PPE with or without minor bronchopleural fistula.

This article has been cited by other articles:

				D. Schneiter, T. Grodzki, D. Lardinois, P. B. Kestenholz, J. Wojcik, B. Kubisa, J. Pierog, and W. Weder Accelerated treatment of postpneumonectomy empyema: A binational long-term study J. Thorac. Cardiovasc. Surg., July 1, 2008; 136(1): 179 - 185. [Abstract] [Full Text] [PDF]

				T. F. Molnar Current surgical treatment of thoracic empyema in adults Eur. J. Cardiothorac. Surg., September 1, 2007; 32(3): 422 - 430. [Abstract] [Full Text] [PDF]

				P. Bagan, F. Boissier, P. Berna, A. Badia, F. L. Pimpec-Barthes, R. Souilamas, and M. Riquet Postpneumonectomy empyema treated with a combination of antibiotic irrigation followed by videothoracoscopic debridement. J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 708 - 710. [Full Text] [PDF]

				S. Zaheer, M. S. Allen, S. D. Cassivi, F. C. Nichols III, C. H. Johnson, C. Deschamps, and P. C. Pairolero Postpneumonectomy empyema: results after the Clagett procedure. Ann. Thorac. Surg., July 1, 2006; 82(1): 279 - 286. [Abstract] [Full Text] [PDF]