Management of empyema after lung resections (pneumonectomy/lobectomy)

Intrathoracic Application of Vacuum Wound Therapy Following Thoracic Surgery

“…Especially the outcome of the most severe intrathoracic wound healing complicationbronchopleural fistula after lung resectionsis associated with considerable morbidity, mortality and costs [5]. There are several therapy options currently available, namely surgi-cal debridement with closed irrigation or open packing and primary or secondary closure with or without muscle flaps or omentum flap [6]. What they all have in common is a lack of consensus on their use as a single line therapy or as a combination of these procedures.…”

Video-Thoracoscopic Management of Postpneumonectomy Empyema

“…Its incidence ranges from 2% to 16%. 1,2 It is also associated with a high perioperative mortality rate up to 25% if no BPF is associated 6,12 and reaches 70% in case of concomitant BPF. 13 When no BPF is present or when a minor BPF is discovered at bronchoscopy, the management of PPE is controversial.…”

“…Empyema of the pleural cavity after pneumonectomy is a major complication with a reported incidence ranging from 2% to 16% and a high mortality rate. 1,2 Prognosis and management of postpneumonectomy empyema (PPE) depends on the presence or absence of a bronchopleural fistula (BPF), which may be associated with the empyema up to 80% of these cases. 1 When a large BPF is present, an aggressive surgical approach is required for closure of the fistula, lavage of the pleural space, and the drainage of the pleural cavity.…”

Modified Technique for Thoracomyoplasty after Posterolateral Thoracotomy

“…Clagett and Geraci developed the concept of open drainage and "secondary sterilization" [9]. This treatment is an accepted procedure in this group of patients [10]. Failure of this technique is often the result of persistent or recurrent bronchial stump fistulas.…”