Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8114
Peer-review started: April 10, 2021
First decision: May 11, 2021
Revised: May 24, 2021
Accepted: August 12, 2021
Article in press: August 12, 2021
Published online: September 26, 2021
Processing time: 159 Days and 3.8 Hours
Empyema is a severe complication following pneumonectomy that is associated with high morbidity and mortality rates. Although there are a wide variety of treatment options, successful management remains challenging when this condition is combined with a large cavity in very thin patients who had previously undergone a posterolateral thoracotomy.
We reported the case of a thin, 63-year-old man with a progressive pulmonary cyst who underwent left pneumonectomy via posterolateral thoracotomy 23 years ago. After an initially uneventful postoperative course, he was readmitted with empyema and a large cavity 21 years after surgery. He was successfully treated with limited thoracoplasty, followed by free vastus lateralis musculocutaneous flap transposition.
This case highlights that the treatment mode of limited thoracoplasty and free vastus lateralis musculocutaneous flap transposition is safe and effective for the management of postpneumonectomy empyema with a large cavity in thin patients who had previously undergone a posterolateral thoracotomy.
Core Tip: Empyema is a severe complication following pneumonectomy and is associated with high morbidity and mortality rates. Although there are a wide variety of treatment options, successful management remains challenging. We performed limited thoracoplasty and free vastus lateralis musculocutaneous flap transposition for postpneumonectomy empyema with a large cavity in a thin patient who had previously undergone a posterolateral thoracotomy. This treatment mode is safe and effective for such patients.