Conservative treatment of empyena after right sleeve pneumonectomy and prophylactic omentopexy - A case report.

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The patient was a 61-year old male who had c-III B adenocarcinoma originating in the right middle lobe of the lung. Right sleeve pneumonectomy was performed with R2a lymph node dissection, resection of part of the pericardium, and replacement with a Gore Tex sheet. Omentopexy was used to cover the tracheo bronchial anastomosis, stumps of the great vessels and the Gore Tex sheet.<BR>He developed a wound infection on the 5th postoperative day and empyema on the 6th postoperative day. Empyema was completely cured by chest drainage and irrigation of the infected pneumonectomy space with physiological saline containing antiseptic povidone iodine (Isodine) and minocycline HCI (Minomycin).<BR>The prophylactic omentopexy was very helpful in the cure of empyema at the following points.<BR>1) Just at the onset of empyema, minor leakage was found at the tracheo-bronchial anastomosis, but it healed in a few days.<BR>2) Although part of the pericardium was replaced with a Gore Tex sheet in the infected pneumonectomy space, empyema could be cured with conservative treatment.
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