Thorac Cardiovasc Surg 2008; 56(6): 372-374
DOI: 10.1055/s-2007-965766
Case Reports

© Georg Thieme Verlag KG Stuttgart · New York

Accelerated Treatment for Post-Lobectomy Empyema: New Indication for an Established Procedure

A. Wolthuis1 , R. Krishnadas1 , R. Berrisford1 , P. Froeschle1
  • 1Department of Thoracic Surgery, Royal Devon and Exeter Foundation Hospital Trust, Exeter, United Kingdom
Further Information

Publication History

Received July 16, 2007

Publication Date:
14 August 2008 (online)

Introduction

Management of pleural empyema, first described by Hippocrates 2400 years ago, continues to be a surgical challenge, especially if it occurs after lung resection [1]. The risk of empyema after a lobectomy or minor lung resection is reported to be 0.01 % to 2 % [2]. Local treatment options include simple thoracocentesis and tube thoracostomy as well as myoplasty and thoracoplasty with a perioperative mortality for some of the more invasive procedures as high as 13 % [3]. The Weder group has introduced the intriguing concept of an accelerated treatment for postpneumonectomy empyema by performing fixed-interval redo-thoracotomies with debridement and thus achieving a definitive closure of the previously infected hemithorax within eight days, with a mean in-hospital time of 17 days [4]. We present a case report in which the original principles of accelerated treatment were successfully applied to a post-lobectomy empyema instead.

References

FRCS Rakesh Krishnadas

Department of Thoracic Surgery
Royal Devon and Exeter Foundation Hospital Trust

H209, Barrack Road

Exeter EX2 5DW

United Kingdom

Phone: + 44 13 92 40 26 89

Fax: + 44 13 92 40 21 75

Email: rakeshkrishnadas@yahoo.com