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Sakakura N, Mizuno T, Kuroda H, et al. Surgical treatment of empyema after pulmonary resection using pedicle skeletal muscle plombage, thoracoplasty, and continuous cavity ablution procedures: a report on three cases. J Thorac Dis. 2016;8(6):1333-9doi: 10.21037/jtd.2016.04.04.
Sakakura, N., Mizuno, T., Kuroda, H., Sakao, Y., & Uchida, T. (2016). Surgical treatment of empyema after pulmonary resection using pedicle skeletal muscle plombage, thoracoplasty, and continuous cavity ablution procedures: a report on three cases. Journal of thoracic disease, 8(6), 1333-9. https://doi.org/10.21037/jtd.2016.04.04
Sakakura, Noriaki, et al. "Surgical treatment of empyema after pulmonary resection using pedicle skeletal muscle plombage, thoracoplasty, and continuous cavity ablution procedures: a report on three cases." Journal of thoracic disease vol. 8,6 (2016): 1333-9. doi: https://doi.org/10.21037/jtd.2016.04.04
Sakakura N, Mizuno T, Kuroda H, Sakao Y, Uchida T. Surgical treatment of empyema after pulmonary resection using pedicle skeletal muscle plombage, thoracoplasty, and continuous cavity ablution procedures: a report on three cases. J Thorac Dis. 2016 Jun;8(6):1333-9. doi: 10.21037/jtd.2016.04.04. PMID: 27293855; PMCID: PMC4886002.
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J Thorac Dis. 2016 Jun;8(6):1333-9. doi: 10.21037/jtd.2016.04.04.

Surgical treatment of empyema after pulmonary resection using pedicle skeletal muscle plombage, thoracoplasty, and continuous cavity ablution procedures: a report on three cases.

Journal of thoracic disease

Noriaki Sakakura, Tetsuya Mizuno, Hiroaki Kuroda, Yukinori Sakao, Tatsuo Uchida

Affiliations

  1. 1 Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan ; 2 Department of Thoracic Surgery, Aichi Cancer Center Aichi Hospital, Okazaki, Japan.

PMID: 27293855 PMCID: PMC4886002 DOI: 10.21037/jtd.2016.04.04

Abstract

We present three cases of postoperative empyema after pulmonary resection: case 1, acute empyema without fistula after lobectomy and chest wall resection; case 2, continuing empyema with fistula and total left residual lung abscess after upper divisionectomy; and case 3, chronic empyema with middle lobe bronchopleural fistula after lower lobectomy. Pedicle skeletal muscle plombage into the cavity, thoracoplasty, and continuous cavity ablution with 24-h instillation of minocycline and saline solution through drains were used for treatment. In case 2, a completion extrapleural left pneumonectomy was concurrently performed. In all three cases, the surgery was successful; however, case 2 developed a massive gastrointestinal hemorrhage, which led to blood aspiration pneumonitis, renal failure, and death. Muscle plombage effectively achieves the closure of empyema cavity and thoracoplasty complements this. When a residual space remains, cavity ablution is considered to be effective. However, concurrent completion lung parenchyma resection might be excessively aggressive.

Keywords: Pulmonary resection; cavity ablution; empyema; muscle plombage; thoracoplasty

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