The comparison of vacuum assisted closure (VAC) and conventional treatment methods in postpneumonectomy empyema cases

Abstract

Aim: Postpneumonectomy empyema is one of the most difficult clinical conditions in thoracic surgery. There is a wide range ofconventional treatment options ranging from tube thoracostomy, antibiotic irrigation to open-window thoracostomy. VacuumAssisted Closure (VAC) therapy is also among the treatment options. In our study we aimed to compare the outcomes and efficiencyof conventional treatment procedures and VAC.Material and Methods: Eighteen male patients (average age 54.8± 18.68), who were diagnosed with postpneumonectomy empyemabetween July 2012 and November 2014, were divided into two groups. Nine patients (Group I) have been treated with conventionalprocedures, while the other nine patients (Group II) have been treated with VAC.Results: Five patients in the Group I were cured in an average of 9.6 months. Four patients underwent additional surgical interventionand they remained in the empyema clinic for 12 months in the follow-up period. Seven patients in the Group II were cured duringthe follow up period of an average of 14.8 months. Two patients who developed bronchopleural fistula remained in the empyemaclinic. Average length of hospital stay is 109.3 days for the Group I and 63 days for the Group II. The treatment of the Group II hasbeen found more successful than the Group I in terms of pain status assessment, patient’s comfort and postoperative cosmeticappearance.Conclusions: VAC group success rate has been found higher in terms patient’s comfort, the length of hospital stay and duration ofempyema. Further studies are required to establish the success of this procedure.