PATIENTS, METHOD AND RESULTS: Twenty-four patients with post-
pneumonectomy pyothorax cared for between 1991 and 2000 were reviewed retrospectively. There were 15 men and 9 women, mean age 34 years.
Pneumonectomy was indicated for tuberculous
pyothorax and destroyed lung (n = 8), 8 destroyed lung (n = 8), pulmonary aspergilloma (n = 2),
pulmonary hydatidosis (n = 2), bronchial dilatation (n = 2),
lung cancer (n = 1), and bullet
wound (n = 1). The patients were divided into two groups according to presence or absence of
bronchial fistula: group 1, 19 patients with without
bronchial fistula, and group 2 5 with
bronchial fistula. Fourteen patients in group 1 (73.7%) achieved definitive cure, 12 after drainage and washout (63%) at mean delay of 45 days and 2 after drainage and washout with
thoracoplasty. Five patients did not respond to hospital drainage and washout and remained under definitive ambulatory drainage as they declined further surgical treatment. One death occurred in this group. Two patients in group 2 (40%) achieved definitive cure, one after daily aspiration, and the other after
thoracoplasty. Two fistulae in one patient were treated with nitratage. For this patient, we also attempted revision of the bronchial stube via posterior throacotomy, the closure of the
bronchial fistula using an intercostal muscle flap associated with
thoracoplasty. All these methods failed. There were two deaths in this group.
CONCLUSION: