title: Usefulness of Thoracoscopic Debridement for Chronic Empyema after an Extrapleural Pneumonectomy.
abstract: We present the case of a 65-year-old Japanese man diagnosed with chronic empyema (without a bronchopleural fistula) that occurred 7 months after he underwent an extrapleural pneumonectomy for right malignant pleural mesothelioma (MPM). Following thoracic drainage and irrigation for 1 month, we performed surgery by a thoracoscopic approach, in light of his general condition. We performed debridement and removal of the Gore-Tex polytetrafluoroethylene (PTFE) patch that had been used for the reconstruction of the diaphragm and the pericardium. The empyema had not relapsed when he died from recurrence of the MPM at 4 months after the thoracoscopic surgery. This patient's case suggests that thoracoscopic debridement and patch removal can be a therapeutic option for not only early-stage (exudative or fibrinopurulent) empyema but also late-stage (organized and chronic) empyema without a bronchopleural fistula, particularly for patients in poor general condition.
authors.affiliation: Department of Thoracic Surgery, Okayama University Hospital, Okayama 700-8558, Japan.torigoemarket3@yahoo.co.jp.
authors.forename: Hidejiro
authors.initials: H
authors.lastname: Torigoe
authors.forename: Shinichi
authors.initials: S
authors.lastname: Toyooka
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Junichi
authors.initials: J
authors.lastname: Soh
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyoshi
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000628:therapy; D003646:Debridement / Q000379:methods*; D004653:Empyema / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D011013:Pneumonectomy / Q000379:methods*; D013906:Thoracoscopy / Q000379:methods*