Video-assisted thoracic surgery (VATS) for empyema following pneumonectomy

In a 4-year period two right-sided empyemas occurred following a total of 3 9 pneumonectomies for lung cancer. In another case pneumonectomy was perfor med for left-sided lung cancer with concomitant empyema as an emergency pro cedure in a patient referred from an outside hospital. Empyema was treated with repeated thoracoscopic debridements and intermittent lavage with polyv inylpyrrolidine-iodine solution and streptocinase/streptodornase. Three to seven thoracoscopies were required to sterilize the pleural cavity. After a median follow-up of 14 months all three patients are well and without any evidence of infection. VATS is suitable for definitive treatment of postpne umonectomy empyema and is associated with excellent functional and cosmetic results.