A case of thoracoscopic surgery with high flow jet ventilation for contralateral empyema after total right pneumnectomy

• Published in: The Journal of the Japanese Association for Chest Surgery Vol. 34; no. 7; pp. 746 - 750
• Main Authors: Mori, Hiroki, Nose, Naohiro, Yano, Takao, Tomita, Masaki, Nakamura, Kunihide
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Association for Chest Surgery 15.11.2020
• Subjects: after pneumonectomy; empyema; HFJV; high frequency jet ventilation
• ISSN: 0919-0945; 1881-4158
• DOI: 10.2995/jacsurg.34.746

We herein report a case of thoracoscopic surgery using high-frequency jet ventilation (HFJV) for left acute empyema after total right pneumonectomy. A 71-year-old man had undergone right pneumonectomy at 64 years old for squamous cell carcinoma of the right lung. At his recent presentation, the patient complained of left chest pain. He was treated with antibiotics for pleurisy, but left pleural effusion and dyspnea worsened. Chest drainage was performed. Cloudy pleural effusion was observed, and the patient was referred to our department for acute empyema. As computed tomography revealed pleural effusion in multiple cavities, we decided to perform decortication by means of video-assisted thoracic surgery. Surgery was performed thoracoscopically with the left lung ventilated with HFJV and started in the right lateral position. Although the lungs were slightly inflated by HFJV, we were able to secure a visual field and working space by excluding them. The postoperative course was uneventful, and the patient was discharged on the sixth postoperative day.