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A Journal on Surgery

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Chirurgia 2008 February;21(1):37-40

language: English

Successful videothoracoscopic debridement for postpneumonectomy empyema without bronchopleural fistula

Maeda R. 1, Isowa N. 1, Tokuyasu H. 2, Kawasaki Y. 2

1 Division of Thoracic Surgery Matsue Red Cross Hospital, Shimane, Japan
2 Division of Respiratory Medicine Matsue Red Cross Hospital, Shimane, Japan


We report a case of postpneumonectomy methicillin-resistant Staphylococcus aureus (MRSA) empyema successfully treated by videothoracoscopic debridement. A 67-year-old malnourished man underwent left pneumonectomy for squamous cell carcinoma with lung abscess in the left lower lobe. Postoperatively he developed left-sided acute empyema without bronchopleural fistula caused by MRSA. Although closed tube thoracostomy and irrigation were performed, cultures of left pleural effusion remained positive for MRSA. Videothoracoscopic debridement was performed on postoperative day 55, followed by closed tube drainage with saline solution lavage for 12 days, and finally the empyema was successfully managed. The videothoracoscopic approach for postpneumonectomy empyema without bronchopleural fistula, especially in the patients with poor general condition, should be considered.

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