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Treatment of persistent postpneumonectomy empyema by vacuum-assisted management: an analysis of nine patients

Ali Celik1, Erdal Yekeler, Ertan Aydın

  • 1Department of Thoracic Surgery, Atatürk Chest Disease and Thoracic Surgery Training and Research Hospital, Keçiören, Ankara, Turkey.

The Thoracic and Cardiovascular Surgeon
|December 11, 2012
PubMed
Abstract

Insights

Vacuum-assisted management (VAM) effectively treats postpneumonectomy empyema (PPE), offering a safe and successful alternative to conventional methods. This approach aids in continuous drainage and pouch obliteration, improving patient outcomes.

Area of Science:

  • Thoracic Surgery
  • Surgical Innovation
  • Infectious Disease Management

Background:

  • Postpneumonectomy empyema (PPE) presents significant challenges including prolonged hospitalization, patient discomfort, and high mortality rates with conventional treatments.
  • Vacuum-assisted management (VAM) emerges as a potential solution to mitigate these adverse outcomes.

Purpose of the Study:

  • To evaluate the efficacy and safety of intrathoracic vacuum-assisted management (VAM) for treating postpneumonectomy empyema (PPE).
  • To assess VAM's role in continuous drainage and promoting pouch obliteration through enhanced tissue granulation.

Main Methods:

  • VAM was applied to nine patients diagnosed with PPE between July 2010 and September 2011.
  • The procedure involved continuous drainage of the empyema cavity and facilitation of granulation for pouch obliteration.

Main Results:

  • Treatment success was achieved in 88.9% (8 out of 9) of patients.
  • In patients without fistula (n=7), VAM led to empyema resolution and pouch obliteration.
  • In patients with fistula (n=2), VAM was initiated after fistula closure, also demonstrating success.
  • The mean hospital stay was 36.5 days, with a mean follow-up of 10.9 months in successfully treated cases.

Conclusions:

  • Intrathoracic vacuum-assisted management (VAM) is an effective and safe therapeutic option for postpneumonectomy empyema (PPE).
  • VAM facilitates continuous drainage and promotes healing, leading to successful treatment outcomes in a majority of patients.

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