Balanced drainage of the contaminated pneumonectomy space

The patient who needs a pneumonectomy but has an infected pleural cavity faces the probability of an empyema of the pneumonectomy space. Balanced drainage of a contaminated space may avoid this very serious complication. A patient with obstructing bronchogenic carcinoma associated with distal parenchymal suppuration and empyema is discussed. A pneumonectomy with balanced drainage of the pleural space was performed. After three weeks the mediastinum was stable, and daily irrigation of the space with antibiotic solution was begun. Following fourteen days of irrigation, the cavity was filled with antibiotic solution and closed. Follow-up has shown no subsequent space problems or infection. Balanced drainage is a useful method of dealing with a contaminated pneumonectomy space.