[Thoracoscopic therapy of pleural empyema after pneumonectomy]

In a 4-year period two right-sided empyemas occurred following a total of 39 pneumonectomies for lung cancer. In another case pneumonectomy was performed for left-sided lung cancer with concomitant empyema as an emergency procedure in a patient referred from an outside hospital. Empyema was treated with repeated thoracoscopic debridements and intermittent lavage with polyvinylpyrrolidine-iodine solution and streptocinase/streptodornase. Three to seven thoracoscopies were required to sterilize the pleural cavity. After a median follow-up of 14 months all three patients are well and without any evidence of infection. VATS is suitable for definitive treatment of postpneumonectomy empyema and is associated with excellent functional and cosmetic results.