PING-PONG BALL PLOMBAGE FOR RIGHT POSTPNEUMONECTOMY SYNDROME IN CHILDREN

Background/Purpose: Right postpneumonectomy syndrome is a rare complic ation of pneumonectomy characterized by exertional dyspnea resulting f rom mediastinal shift into the empty hemithorax. Historically, this pr oblem has been treated with thoracoplasty, muscle flap transposition, pericardial fixation, and plombage using a variety of materials. Signi ficant postoperative complications have been reported with each of the se methods. In an effort to avoid the problems known to be associated with other plombage materials, we have used sterilized ping-pong balls as plombage to treat the postpneumonectomy syndrome. Methods: Two chi ldren with pneumonectomy syndrome were treated with ping-pong ball plo mbage. Results: Symptoms improved immediately in both patients and pos toperative chest x-rays in each showed a normal cardiac position. Neit her child had a postoperative complication. Six-year follow-up chest f ilms in both children have demonstrated some fluid filling of the ping -pong balls, but no clinical problems attributable to them have been n oted. Conclusion: The authors conclude that ping-pong ball plombage ap pears to be a viable management option in children with right postpneu monectomy syndrome. J Pediatr Surg 33: 1048-1051. Copyright (C) 1998 b y W.B. Saunders Company.