Thoracoplasty for Postpneumonectomy Empyema Associated with Bronchopleural Fistula: A Case Series

Abstract

Thoracoplasty is a historical procedure, initially devised for the treatment of refractory tuberculous empyema. Advances in medical treatments have nearly eliminated the need for this surgical procedure in pulmonary tuberculosis and it is rarely performed or taught in modern day surgical practice. However, few indications still exist, most prominently, in the treatment of postpneumonectomy refractory empyema often but not always associated with a bronchopleural fistula. In this case report, we present two cases of postpneumonectomy refractory empyema treated by thoracoplasty with long-term follow-up.

Keywords

thoracoplasty - empyema - bronchopleural - fistula

• References

• 1 Stefani A, Jouni R, Alifano M , et al. Thoracoplasty in the current practice of thoracic surgery: a single-institution 10-year experience. Ann Thorac Surg 2011; 91 (1) 263-268
• 2 Ng CS, Wan S, Lee TW, Wan IY, Arifi AA, Yim AP. Post-pneumonectomy empyema: current management strategies. ANZ J Surg 2005; 75 (7) 597-602
• 3 Molnar TF. Current surgical treatment of thoracic empyema in adults. Eur J Cardiothorac Surg 2007; 32 (3) 422-430
• 4 Wong PS, Goldstraw P. Post-pneumonectomy empyema. Eur J Cardiothorac Surg 1994; 8 (7) 345-349 , discussion 349–350
• 5 de la Riviere AB, Defauw JJ, Knaepen PJ, van Swieten HA, Vanderschueren RC, van den Bosch JM. Transsternal closure of bronchopleural fistula after pneumonectomy. Ann Thorac Surg 1997; 64 (4) 954-957 , discussion 958–959
• 6 Peppas G, Molnar TF, Jeyasingham K, Kirk AB. Thoracoplasty in the context of current surgical practice. Ann Thorac Surg 1993; 56 (4) 903-909
• 7 Horrigan TP, Snow NJ. Thoracoplasty: current application to the infected pleural space. Ann Thorac Surg 1990; 50 (5) 695-699
• 8 Grégoire R, Deslauriers J, Beaulieu M, Piraux M. Thoracoplasty: its forgotten role in the management of nontuberculous postpneumonectomy empyema. Can J Surg 1987; 30 (5) 343-345
• 9 Dewan RK, Singh S, Kumar A, Meena BK. Thoracoplasty: an obsolete procedure?. Indian J Chest Dis Allied Sci 1999; 41 (2) 83-88
• 10 Zahid I, Routledge T, Billè A, Scarci M. What is the best treatment of postpneumonectomy empyema?. Interact Cardiovasc Thorac Surg 2011; 12 (2) 260-264