Caveats in using vacuum-assisted closure for post-pneumonectomy empyema

Gaetano Rocco, Ciriaco Cecere, Antonello La Rocca, Nicola Martuccia, Rosario Salvi, Eliseo Passera, Marcellino Cicalese

Research output: Contribution to journalArticle


Objectives: Vacuum-assisted closure (VAC) of chronic empyemas can potentially set challenging patients free of prolonged hospitalization by warranting outpatient care. We wanted to test this concept in post-pneumonectomy empyema patients. Methods: Three patients with post-pneumonectomy bronchopleural fistula were subjected to open window thoracostomy (OWT) and subsequently to VAC. The BPFs were closed by endobronchial stents in 2 of the patients. The VAC system was applied at a median time of 35 days (range, 23-113) after pneumonectomy. The patients were scheduled for outpatient visits every three days with complete change of the VAC sponges. Results: Hypotension and acute thoracic pain despite minimal suction applied to the VAC sponges were observed during treatment and eventually caused VAC discontinuation. In one patient,the sponges of the VAC system could not be directly removed through the OWT and careful dissection through VATS under deep sedation was needed. Conclusions: VAC can be of help to obliterate the post-pneumonectomy empyema cavity but its usecan trigger clinically significant complications. Cautious monitoring of the VAC system must be exercised in the early period prior to discharging patients to the outpatientclinic.

Original languageEnglish
Pages (from-to)1069-1071
Number of pages3
JournalEuropean Journal of Cardio-thoracic Surgery
Issue number5
Publication statusPublished - 2012


  • Bronchopleural fistula
  • Empyema
  • Pneumonectomy
  • Vacuum assisted closure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

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