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ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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3/2024
vol. 21
 
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abstract:
Original paper

Enhancing treatment approaches for postpneumonectomy empyema: exploring the role of video-assisted thoracic surgery

Konstantinos Grapatsas
1
,
Arben Xhambazi
1
,
Mohammad Jamshidof
1
,
Emmanouil Dimopoulos
2
,
Benjamin Ehle
3
,
Athanasios Papatriantafyllou
4
,
Francesk Mulita
5
,
Levan Tchabashvili
5
,
Elias Liolis
6
,
Konstantinos Tasios
5
,
Andreas Antzoulas
5
,
Dimitrios Litsas
7
,
Konstantinos Skevis
8
,
Nikolas Drakos
5
,
Efstratios Koletsis
9
,
Manfred Dahm
4
,
Vasileios Leivaditis
4

  1. Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
  2. Department of General and Visceral Surgery, Marienhospital Stuttgart, Stuttgart, Germany
  3. Department of Thoracic Surgery, Asklepios Lung Clinic Munich-Gauting, Gauting, Germany
  4. Department of Cardiothoracic and Vascular Surgery, WestpfalzKlinikum, Kaiserslautern, Germany
  5. Department of Surgery, General University Hospital of Patras, Patras, Greece
  6. Department of Oncology, General University Hospital of Patras, Patras, Greece
  7. Department of Surgery, General Hospital of Lamia, Lamia, Greece
  8. Department of Thoracic Surgery, General Hospital of Rhodos, Rhodos, Greece
  9. Department of Cardiothoracic Surgery, Patras University Hospital, Patras, Greece
Kardiochirurgia i Torakochirurgia Polska 2024; 21 (3): 167-171
DOI: https://doi.org/10.5114/kitp.2024.143457
Online publish date: 2024/09/24
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Introduction
Postpneumonectomy empyema (PPE) poses a substantial postoperative risk, even in the absence of a bronchopleural fistula, often necessitating surgical intervention for resolution.

Aim
To evaluate the efficacy of video-assisted thoracic surgery (VATS) in managing PPE, supported by a comprehensive review of pertinent literature.

Material and methods
Six studies were included in this analysis, encompassing 63 PPE cases treated with VATS. Patient ages ranged from 16 to 74 years, with prevalent bacterial strains identified within the Staphylococcus and Streptococcus genera.

Results
Hospital stays extended up to 94 days, with 4 patients requiring thoracostomy for infection management. Postoperatively, 1 patient succumbed to complications. VATS holds promise as a viable therapeutic modality for definitive PPE management.

Conclusions
In instances of bronchopleural fistula or persistent empyema, consideration should be given to open revision procedures.

keywords:

bronchopleural fistula, video-assisted thoracic surgery, post-pneumonectomy empyema, pneumonectomy complications, thoracic infections
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