Postpneumonectomy Space Research Articles

A Method of Early Irrigation of the Contaminated Postpneumonectomy Space

A modified balanced drainage system was used with other measures in a patient with an obstructing pulmonary carcinoma, infection, and necrosis. Management included right pneumonectomy, perioperative systemic antibiotics, protection of the remaining lung, and a modified balanced drainage system that allowed early irrigation of the postpneumonectomy space. On the tenth postoperative day, irrigations were discontinued, the right chest was filled with an antibiotic solution, and the thoracostomy tubes were removed. The mediastinum remained in a satisfactory position, and the patient recovered without evidence of empyema. He died of a cerebral metastasis five and a half months postoperatively. This method combines principles that have been used for many years. A balanced drainage-irrigation system permits early irrigation of the contaminated postpneumonectomy space while the mediastinum is still mobile. Prolonged hospitalization and formal closure of the thoracostomy sites can be avoided.

Empyema Seven Years After Pneumonectomy

EMPYEMA occurring days to weeks after pneumonectomy is usually diagnosed during the same hospitalization. A late-onset postpneumonectomy empyema may be very difficult to diagnose. In some cases, a new airfluid level appearing on the chest roentgenogram provides a lead to the diagnosis or an empyema necessitatis makes the diagnosis obvious.¹In others, there may be no diagnostic clues. In such patients, a gallium 67 scan may detect empyema in the postpneumonectomy space. <h3>Report of a Case</h3> A 52-year-old man was admitted to the Wood (Wis) Veterans Administration Medical Center on Jan 17, 1978, with cough, shortness of breath, and chills of two weeks' duration. He also noted an elevated temperature of 40 °C orally on one occasion, blood-streaked sputum, and occasional left-sided chest pain on coughing. He had a right-sided pneumonectomy for a bronchial adenoma in 1971, without complications. In February 1976, he was hospitalized for ten days for

Disappearance of fluid from the postpneumonectomy space

Fourteen cases are presented in which there was radiographic evidence that pleural space fluid disappeared in the early period after pneumonectomy. In 11 cases the clinical course was uneventful and the space refilled. Two patients subsequently developed a bronchopleural fistula, and 1 patient suffered from recurrent respiratory injections. This complication was probably due to the presence of a small bronchopleural fistula, in spite of the difficulty experienced in its demonstration. Conservative management is recommended, with frequent clinical and radiologic observations, so that early surgical intervention may be undertaken if an overt bronchopleural fistula results.

Management of Postpneumonectomy Space: Appraisal of a Technique Used in 408 Consecutive Cases

<h2> </h2> A simple instrument, previously used for artificial pneumothorax treatment, was utilized for mediastinal stabilization in the postoperative period following pneumonectomy. The technique was used in 408 consecutive pneumonectomies, and mediastinal equilibrium was achieved in each instance, except where complicated with bronchopleural fistula in the early postoperative period.

The postpneumonectomy space: Factors influencing its obliteration

The postpneumonectomy space: Factors influencing its obliteration