Abstract
BackgroundManagement of postpneumonectomy empyema requires comprehensive strategies, especially when the condition is associated with large bronchopleural fistulae. We report a case involving the simple chest closure of open window thoracostomy with remaining residual space.Case presentationWe performed open window thoracostomy for empyema with a huge bronchial stump dehiscence after right pneumonectomy for a large lung cancer. We definitively closed the chest window infected with chronic persistent Pseudomonas aeruginosa via a simple chest closure technique with the remaining residual space, after repairing the bronchial dehiscence using an omental flap and the appearance of healthy granulation tissue throughout the cavity. The patient died of recurrent cancer 10 months after the definitive chest closure. Until the patient died, there were no symptoms or signs suggestive of recurrent empyema.ConclusionThis simple chest closure technique allows “silent empyema” to be observed carefully, is less invasive, and can even be applied to cases of recurrent cancer.
Highlights
Management of postpneumonectomy empyema requires comprehensive strategies, especially when the condition is associated with large bronchopleural fistulae
The management of postpneumonectomy empyema (PPE) requires comprehensive strategies, especially when it is associated with large bronchopleural fistulae (BPF) or advanced pyothorax
We report a case involving open window thoracostomy (OWT) for Postpneumonectomy empyema (PPE) with BPF, which was definitively closed via a simple chest closure technique with the remaining residual space, following the repair of BPF and the appearance of healthy granulation tissue throughout the cavity
Summary
We can close a thoracostomy using a simple chest closure technique, despite the presence of the residual space, provided that no BPF is noted and healthy granulation tissue covers the whole cavity.
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