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Non-surgical treatment for post pneumonectomy empyema

^a Department of General Thoracic Surgery, 8th floor, Rambam Medical Center, Haifa 31096, Israel
^b Department of Diagnostic Imaging, Rambam Medical Center, Haifa 31096, Israel

^* Corresponding author. Tel.: +972-4-854-2812; fax: +972-4-854-2044
mangn{at}netmedia.net.il

We describe an alternative treatment for postpneumonectomy empyema in patients for which Claggett procedure is inappropriate.

During the years 1990–2002 eight patients with postpneumonectomy empyema were treated by continuous soft tube thoracostomy, intrapleural fibrinolysis and antibiotics. The medical records of these patients were reviewed retrospectively. The procedure was well tolerated by all patients and there were no significant complications during the treatment period. One patient died 9 months postpneumonectomy due to metastatic disease. The remaining patients have successfully completed the treatment with no recurrence of empyema. Continuous soft tube drainage with intrapleural fibrinolysis and antibiotics is a safe treatment for postpneumonectomy empyema in patients who are not appropriate candidates for operative management.

Key Words: Pneumonectomy; Empyema; Thoracostomy