Abstract
(1) background: Postpneumonectomy empyema is often observed in patients after a complete pneumonectomy. The management of these cases can be challenging when the condition of patients is complicated by a bronchopleural fistula. A multidisciplinary approach is required to manage these critically ill patients, especially when they are not suitable candidates for surgery; (2–3) Methods & Results: we report a case of successfully treated postpneumonectomy empyema caused by a bronchopleural fistula and pharmacokinetics of vancomycin installation in pleural cavity using rat experiments; (4) Conclusions The experiments provide evidence that irrigation of the pleural cavity with an antibiotic solution containing vancomycin may be an efficient treatment strategy, especially in the case of an MRSA infection in the thickened pleura.
Highlights
Postpneumonectomy empyema (PPE) is a severe complication, and is often associated with a bronchopleural fistula (BPF)
We selected proper middle portion for representative figures using undertaken at 10× pictures by light microscope (Leica DM4000/600 M, Versatile upright microscope for materials analysis)
Compared with normal pleura, the concentration of injected vancomycin in the thickened pleura markedly decreased in 15 min, but was sustained above the trough level for four hours (Figure 2C,D)
Summary
Postpneumonectomy empyema (PPE) is a severe complication, and is often associated with a bronchopleural fistula (BPF). The operative mortality of PPE with a BPF is approximately 7.1% [1,2]. The traditional management of PPE comprises three procedures: pleural drainage, sterilisation (using an open or closed technique) and obliteration of the pleural cavity with an antibiotic solution or a muscle flap [1]. 2. Case Report In our center, a 61-year-old man underwent a complete right pneumonectomy for squamous cell carcinoma in the right lower lobe. Case Report In our center, a 61-year-old man underwent a complete right pneumonectomy for squamous cell carcinoma in the right lower lobe His medical history included right upper bilobectomy for an aspergilloma four years prior. He was discharged one month following surgery with no complications. IsnixtmheosnitxhsmfonlltohwsifnoglltohweianpgptlhiceaatipopnloicfatthioenAomf pthlaetzAemr dpelavtizce,r tdhevreicwe,etrheenroe wotehreer ncomotphleicractioomnsp,laicnadtitohnesc, oanditihoencoofntdhietipoantioefnthiemppartoiveendt icmonpsriodveerdabcloy.nsiderably
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