CURRENT STRATEGIES FOR THE TREATMENT OF THE POST-PNEUMONECTOMY EMPYEMA
Abstract:
The post-pneumonectomy empyema remains a feared complication in modern thoracic
surgery. The classic approach is based mainly on open thoracic window, alone or part of more complex
strategies, as well as on thoracoplasty and mioplasty of the infected space. During the last years, some
new promising strategies have emerged, allowing a faster healing and/or a more limited chest wall
mutilation (negative pressure therapy associated with open thoracic window, thoracoscopic debridement
and the accelerated version of the Clagett procedure proposed by Weder and Grodzky teams). Each of
the proposed methods has advantages and disadvantages, which are difficult to put in balance. The
heterogenicity and the small number of the reported series, associated with the lack of any prospective
randomised study make an evidence-based approach almost impossible.
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