PMID: 11932161Apr 5, 2002Paper

Prevention of recurrent empyema after pneumonectomy for chronic infection

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Didier SchneiterWalter Weder

Abstract

Pneumonectomy in chronic pulmonary infection with empyema is associated with a high mortality rate and an increased risk of recurrent empyema. The surgical resection is technically demanding, and successful management continues to be a challenge. We evaluated a concept which combines (pleuro-)pneumonectomy or completion pneumonectomy with surgical debridement of the pleural cavity and packing with povidine-iodine soaked dressings. The debridement and packing is repeated in the operating theater after 48 h until the chest cavity is macroscopically clean. Finally, the pleural space is obliterated with antibiotic solution. Between February 1997 and October 2000, 11 patients (average age of 59 years, ranging from 25 to 84) with destroyed lung caused by tuberculosis (six), aspergilloma (two), bronchiectasis (one), esophago-pleural fistula (one) or broncho-pleural fistula after lobectomy for bronchial carcinoma (one) and ongoing chronic infection with acute empyema (ten) (25-2500 days between first and definitive therapy) were treated. Pleural culture findings showed Aspergillus in four, Mycobacterium in two, Enterococcus in two, Candida in one and Staphylococcus in one, respectively. The mean number of interventions was 2.9 (2-4). T...Continue Reading

Citations

Jul 25, 2007·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Thomas F Molnar
Jun 21, 2011·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Lianqi BaiZikun Liang
Jun 24, 2005·ANZ Journal of Surgery·Calvin S H NgAnthony P C Yim
Sep 24, 2008·Current Problems in Surgery·A Thomas Pezzella, Wentao Fang

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