Radical treatment of postpneumonectomy emphyema bronchopleural fistula with minimally invasive surgery.
Radical debridement of the pleural cavity and packing with wet dressing of iodine and closure of the fistula with omentopexy. Finally the pleural space is obliterated with saline contaning antibiotics after a re-thoracotomy. In stead of repeated thoracotimies the pleural cavity is cleared and the wet dressing is changed by video assisted thoracic surgery (VATS). In addition systemic antibiotica treatment is given
3 patients with postpneumonectomy emphyema and bronchopleural fistula were treated with VATS follow up instead of the traditional re-thoracotomies. All 3 had 2 VATS follow up and could be discharged without signs of infection and without tubes. Hospitalisation time mean 15 days (14-17 days)
Minimally invasive repeated surgical procedure combined with closure on bronchopleural fistula is possibleCLINICAL IMPLICATION: This procedure is less traumatic to critically ill patients and procedure is less time consuming than the traditionally repeated thoracotomies
H.J. Hansen, None.