Post-Pneumonectomy Empyema(PPE) is a relatively uncommon but serious complication. And the management of it remains a disturbing and controversial area in the field of general thoracic surgery. Many methods have described and have had varying
degrees of
success.
For the purpose of providing the guideline for management of post-pneumonectomy empyema, we reviewed our experiences of treatment of PPE from January 1985. To December 1992. There were 17 cases, which consist 7.9% of all pneumonectomy cases for
that
period.
There were 13 male and 4 female patients with mean age of 47.1*16.2 yrs old.
Both chest has the same incidence.
The most common disease for prior pneumonectomy was tuberculosis, but the PPE was the most frequently occurred in empyema.
The duration between pneumonectomy and PPE was 44.7*81.1 months, where 58.8% of patients occurred within 1 month.
Fever was the most frequent complaint and wound dischrge was detected in less than half of patients.
There were 2 in-hospital mortalities.
Mostly, in 13 cases, we did Eloesser operation. Five of them could finish second Clagett procedure, but one had recurrence. Four bronchopleural fistular patients underwent 3 single stage muscle flapelosure and 1 direct closure with modified
Clagett
procedure. None had recurrence.
Mean follow-up duration is 30.9*22.3months.
There was 1 late death which was not related to PPE but to Malignancy recurrence. (Korean J Thoracic Cardiovas Surg 1993;26:845-50)
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