The Annals of Thoracic Surgery, Vol 31, 464-468, Copyright © 1981 by The Society of Thoracic Surgeons
A method of early irrigation of the contaminated postpneumonectomy space
NM Katz and RB McElvein
A modified balanced drainage system was used with other measures in a
patient with an obstructing pulmonary carcinoma, infection, and necrosis.
Management included right pneumonectomy, perioperative systemic
antibiotics, protection of the remaining lung, and a modified balanced
drainage system that allowed early irrigation of the postpneumonectomy
space. On the tenth postoperative day, irrigations were discontinued, the
right chest was filled with an antibiotic solution, and the thoracostomy
tubes were removed. The mediastinum remained in a satisfactory position,
and the patient recovered without evidence of empyema. He died of a
cerebral metastasis five and a half months postoperatively. This method
combines principles that have been used for many years. A balanced
drainage-irrigation system permits early irrigation of the contaminated
postpneumonectomy space while the mediastinum is still mobile. Prolonged
hospitalization and formal closure of the thoracostomy sites can be
avoided.
