Treatment of Persistent Postpneumonectomy Empyema by Vacuum-Assisted Management: An Analysis of Nine Patients

Abstract

Conventional treatment methods in postpneumonectomy empyemas (PPE) are associated with long stay in hospital, poor patient comfort, and high rate of postoperative mortality. Vacuum-assisted management (VAM) may be helpful in solving these problems. VAM was performed on nine patients with PPE in our clinic between July 2010 and September 2011 to provide continuous drainage of empyema in the pouch and to improve empyema with obliteration of the pouch by accelerating tissue granulation. All nine patients were men (mean age: 54.5 years; range: 18-68 years). Empyema resolution and obliteration of the pouch were achieved with VAM in the cases with empyema without fistula (n = 7) after the pneumonectomy. In the patients with fistula (n = 2), VAM was performed after closure of the fistula. Mean duration of hospital stay was 36.5 (12-57) days. The treatment was successful in eight of nine patients (88.9%). Mean duration of follow-up in the successfully treated patients was 10.9 (3-17) months. Intrathoracic VAM was effective and safe in the treatment of PPE.