Management of Post-Pneumonectomy Empyema

Song, Jong Pil; Jung, Seung Hyuck; Hur, Yong; Kim, Byung Yeol; Lee, Jung Ho; Ahn, Wook Su

Abstract

BACKGROUND: Post-pneumonectomy empyema(PPE) is an uncommon but a serious complication. The management remains as challenge for general thoracic surgeons. MATERIAL AND METHOD: During the period of January 1990 to December 1996, we evaluated the results of 20 patients with post-pneumonectomy empyema. RESULT: Sex ratio were 15 male and 5 female patients with mean age of 41.5+/-21.5 yrs. The occurrence ratio of left to right side was 8:12. The most common disease for prior pneumonectomy was pulmonary tuberculosis. The duration between pneumonectomy and PPE was variable in 1 month to 6yrs. Fever was the most frequent symptom and S. aureus was the most frequent pathogen. In 13 cases, there were combined with BPF. Four patients underwent trans-sternal closure, and Clagett procedure was performed. There was one recurrence that later underwent muscle plombage and omentopexy later. Nine patients underwent omentopexy, muscle plombage and thoracoplasty. There were 7 cases that were not combined with BPF. All 7 patients underwent thoracoplasty, and two of them were combined with muscle plombage. Mean follow-up duration is 40+/-32.3 months. There were no late deaths nor recurrences of PPE.
CONCLUSION
We conclude that early diagnosis and proper drainage in PPE patients are important in its initial stage of management, and also management is completely achieved in thoracoplasty with muscle plombage or omentopexy.