CARDIOVASCULAR ENGINEERING Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
	Volume 6, 2001, No 1

Time-Saving Procedure in the Treatment of Postpneumonectomy Empyema
T. Grodzki, J. Wójcik, J. Alchimowicz, L. Kochanowski, J. Pieróg, B. Kubisa

Background: Postpneumonectomy empyema is a life-threatening complication. Treatment usually involves many time- and cost consuming surgical procedures. Walter Weder from University Hospital in Zurich has proposed a new approach to the problem. His method allows to avoid thoracoplasty, shortens hospital stay and restores aseptic postpneumonectomy cavity. Our goal was to evaluate the method in patients treated by permanent chest drain carrying for long time. 
Methods: 10 men with postpneumonectomy empyema (6 of them with concomitant bronchopleural fistula) underwent procedure based on three thoracotomies in one week: the first one allows to make a debridement of chest cavity and to close bronchial stump fistula. Large gauze mops soaked in betadine are installed into the cavity at the end of the first thoracotomy for 48 hours. Then they are replaced by new ones. During the third (last) thoracotomy the chest cavity is fulfilled by a mixture of antibiotics and closed definitively without drainage. No thoracoplasty is performed afterwards. 
Results: No perioperative mortality or severe morbidity was observed. 8 patients were discharged from the hospital on the postoperative day 7. Two patients suffered from recurrence of bronchopleural fistula and required large thoracoplasty. 
Conclusions: The procedure proposed by Weder can be added to the armamentarium of thoracic surgeons. It proved to be safe and useful for patients and gave good functional result. Possible recurrence of fistula is a potential disadvantage of the method.

(CVE. 2001; 6 (1): 51-55)

Key words: postpneumonectomy empyema, surgical treatment, new approach, time-saving

Tomasz Grodzki, M.D.
Thoracic Surgery Department
Regional Hospital for Lung Diseases
70-891 Szczecin 20 Zdunowo
Poland
E-mail: grodzki@grodzki.szczecin.pl

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