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

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

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