| Peer-Reviewed

Physiopathology, Microbics and Administration of the Pleural Space with Empyema Following Left Pneumonectomy: A Case Report and Discussion

Received: 27 December 2021     Accepted: 19 January 2022     Published: 9 February 2022
Views:       Downloads:
Abstract

In 2016 a middle age man has been operated urgently of left pneumonectomy because of bronchiectasiae with life-threating emoptysis. The Patologist described the entire lung destroyied by a massive inflammatory process. Almost a year later from intervention patient developped broncho - pleural fistula (BPF) on the left main bronchial stump with the onset of a dramatic empyema. After an unsuccessful attempt of endoscopic proceeding to fix the bronchial fistula with cyanoacrylate an Open Window Thoracostomy (OWT) was opened and infection disappeared. Afterwards patient went on outpatient for regular medications. Unfortunately despite of local treatment with antibiotics the pleural space resulted continuously infected and no indication to close the pleural cavity has been considered. Today patient is well and has a normal quality of life. For a patient with an OWT in good health condition also regular medications on outpatient seem reasonable and acceptable if surgery is not appropriate or refused.

Published in Journal of Surgery (Volume 10, Issue 1)
DOI 10.11648/j.js.20221001.15
Page(s) 23-26
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Microbiology, Broncho–pleural Fistula, Post-pneumonectomy Empyema

References
[1] Eerola S, Virkkula L, Varstela E. Treatement of postpneumonectomy empyema and associated bronchopleural fistula. Experience of 100 consecutive postpneumonectomy patients. Scand J Thorac Cardiovasc Surg. 1988; 22: 235-9.
[2] Massard G, Lyons G, Wihlm JM, Fernoux P, Dumont P, Kessler R et al. Early and long – term results after completion pneumonectomy. Ann Thorac Surg. 1995; 59: 196-200.
[3] Higgins GA, Beebe GW. Bronchogenic carcinoma. Factors in survival. Arch Surg. 1967; 94: 539-49.
[4] Patel RL, Townsend ER, Fountain SW. Elective pneumonectomy: factors associated with morbidity and operative mortality. Ann Thorac Surg. 1992; 54: 84-8.
[5] Scarci Marco, Udo Abah, Piergiorgio Solli, Aravinda Page, David Waller, Paul van Schil, Franca Melfi et al. “EACTS expert consensus statement for surgical management of pleural empyema”. European journal of cardio-thoracic surgery 48, no. 5 (2015): 642–653.
[6] Antonio Mazzella, Alessandro Pardolesi, Patrick Maisonneuve, Francesco Petrella, Domenico Galetta, Roberto Gasparri, Lorenzo Spaggiari. Bronchopleural Fistula After Pneumonectomy: Risk Factors and Management, Focusing on Open-Window Thoracostomy. Semin Thorac Cardiovasc Surg. Spring 2018; 30 (1): 04-113.
[7] Domenico Galetta, Lorenzo Spaggiari. Video-Thoracoscopic Management of Postpneumonectomy Emyema. Thorac Cardiovasc Surg 2018; 66 (08): 701-706.
[8] Deschamps C, Bernard A, Nichols FC, Allen MS, Miller DL, Trastek VF et al. Empyema and bronchopleural fistula after pneumonectomy: factors affecting incidence. Ann Thorac Surg. 2001; 72: 243-8.
[9] Peter H. Hollaus, MD, Franz Lax, MD, Phd, Dan Janakiev, MD, Paolo Lucciarini, MD, Elfi Katz, MD, Alois Kreuzer, Md, and Nestor S. Pridun, MD. Endoscopic Treatment of Postoperative Bronchopleural Fistula: Experience with 45 Cases. Ann Thorac Surg 1998; 66: 923-7.
[10] O. Bylicki, J-M Peloni, D Loheas, J Turc, F Petitjean, M Puidupin, P Mulsant, J-M Dot. Endoscopic management of broncho - pleural fistula in a patient with acute respiratory distress syndrome after pneumonectomy. Rev Pneumol Clin. 2012 Aug; 68 (4): 269-72.
[11] Paolo Laperuta, Filomena Napolitano, Alessandro Vatrella, Rosa Maria Di Crescenzo, Antonio Cortese, Vincenzo Di Crescenzo. Post-Pneumonectomy broncho-pleural fistula successfully closed by open-window thoracostomy associatedwith V. A. C. therapy. Int J Surg. 2014; 12 Suppl 2: S17-S19.
[12] Regnard JF, Alifano M, Puyo P, Fares E, Magdeleinat P, Levasseur P. Open window thoracostomy followed by intrathoracic flap transposition in the treatment of empyema complicating pulmonary resection. J Thorac Cardiovasc Surg. 2000; 120: 270-5.
[13] Massera F, Robustellini M, Pona CD, Rossi G, Rizzi A, Rocco G. Predictors of successful closure of open window thoracostomy for postpneumonectomy empyema. Ann Thorac Surg. 2006; 82: 288-92.
[14] Danail B Petrov, Dragan Subotic, Georgi S Yankov, Dinko G Valev, Evgeni V Mekov. Treatment Optimization of Post-pneumonectomy Pleural Empyema. Folia Med (Plovdiv).2019 Dec 31; 61 (4): 500-505.
[15] Jean-Baptiste Stern, Ludovidc Fournel, benjamin Wyplosz, Philippe Girard, Malik Al Nakib, Dominique Gossot, Agathe Seguin-Givelet. Early and delayed post-pneumonectomy empyemas: Microbiology, management and prognosis. Clin Respir J. 2018 Apr; 12 (4): 1753-1761.
Cite This Article
  • APA Style

    Colaut Flavio, Piazza Aurelio, Baldasso Francesco, Stecca Tommaso, Massani Marco. (2022). Physiopathology, Microbics and Administration of the Pleural Space with Empyema Following Left Pneumonectomy: A Case Report and Discussion. Journal of Surgery, 10(1), 23-26. https://doi.org/10.11648/j.js.20221001.15

    Copy | Download

    ACS Style

    Colaut Flavio; Piazza Aurelio; Baldasso Francesco; Stecca Tommaso; Massani Marco. Physiopathology, Microbics and Administration of the Pleural Space with Empyema Following Left Pneumonectomy: A Case Report and Discussion. J. Surg. 2022, 10(1), 23-26. doi: 10.11648/j.js.20221001.15

    Copy | Download

    AMA Style

    Colaut Flavio, Piazza Aurelio, Baldasso Francesco, Stecca Tommaso, Massani Marco. Physiopathology, Microbics and Administration of the Pleural Space with Empyema Following Left Pneumonectomy: A Case Report and Discussion. J Surg. 2022;10(1):23-26. doi: 10.11648/j.js.20221001.15

    Copy | Download

  • @article{10.11648/j.js.20221001.15,
      author = {Colaut Flavio and Piazza Aurelio and Baldasso Francesco and Stecca Tommaso and Massani Marco},
      title = {Physiopathology, Microbics and Administration of the Pleural Space with Empyema Following Left Pneumonectomy: A Case Report and Discussion},
      journal = {Journal of Surgery},
      volume = {10},
      number = {1},
      pages = {23-26},
      doi = {10.11648/j.js.20221001.15},
      url = {https://doi.org/10.11648/j.js.20221001.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221001.15},
      abstract = {In 2016 a middle age man has been operated urgently of left pneumonectomy because of bronchiectasiae with life-threating emoptysis. The Patologist described the entire lung destroyied by a massive inflammatory process. Almost a year later from intervention patient developped broncho - pleural fistula (BPF) on the left main bronchial stump with the onset of a dramatic empyema. After an unsuccessful attempt of endoscopic proceeding to fix the bronchial fistula with cyanoacrylate an Open Window Thoracostomy (OWT) was opened and infection disappeared. Afterwards patient went on outpatient for regular medications. Unfortunately despite of local treatment with antibiotics the pleural space resulted continuously infected and no indication to close the pleural cavity has been considered. Today patient is well and has a normal quality of life. For a patient with an OWT in good health condition also regular medications on outpatient seem reasonable and acceptable if surgery is not appropriate or refused.},
     year = {2022}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Physiopathology, Microbics and Administration of the Pleural Space with Empyema Following Left Pneumonectomy: A Case Report and Discussion
    AU  - Colaut Flavio
    AU  - Piazza Aurelio
    AU  - Baldasso Francesco
    AU  - Stecca Tommaso
    AU  - Massani Marco
    Y1  - 2022/02/09
    PY  - 2022
    N1  - https://doi.org/10.11648/j.js.20221001.15
    DO  - 10.11648/j.js.20221001.15
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 23
    EP  - 26
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20221001.15
    AB  - In 2016 a middle age man has been operated urgently of left pneumonectomy because of bronchiectasiae with life-threating emoptysis. The Patologist described the entire lung destroyied by a massive inflammatory process. Almost a year later from intervention patient developped broncho - pleural fistula (BPF) on the left main bronchial stump with the onset of a dramatic empyema. After an unsuccessful attempt of endoscopic proceeding to fix the bronchial fistula with cyanoacrylate an Open Window Thoracostomy (OWT) was opened and infection disappeared. Afterwards patient went on outpatient for regular medications. Unfortunately despite of local treatment with antibiotics the pleural space resulted continuously infected and no indication to close the pleural cavity has been considered. Today patient is well and has a normal quality of life. For a patient with an OWT in good health condition also regular medications on outpatient seem reasonable and acceptable if surgery is not appropriate or refused.
    VL  - 10
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • General Surgery and Thoracic, City Hospital, Treviso, Italy

  • General Surgery and Thoracic, City Hospital, Treviso, Italy

  • Infectious Disease Unit, City Hospital, Treviso, Italy

  • General Surgery and Thoracic, City Hospital, Treviso, Italy

  • General Surgery and Thoracic, City Hospital, Treviso, Italy

  • Sections