Staniforth Edward, Taberham Rhona, Cogswell Lucy, Belcher Elizabeth
Medical School, University of Oxford, Oxford, UK.
Department of Thoracic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
BMJ Case Rep. 2025 Mar 18;18(3):e263481. doi: 10.1136/bcr-2024-263481.
Postpneumonectomy syndrome is a rare complication following pneumonectomy. Repositioning of the mediastinum via insertion of prosthetic implants into the postpneumonectomy space can provide symptomatic relief. We present a case of a man in his early 70s presenting with empyema necessitans 8 years after the implantation of silicon-saline prostheses for the management of postpneumonectomy syndrome. Excision of the chest wall sinus, re-do right thoracotomy and removal of the infected silicon-saline prostheses and postprocedural intrapleural irrigation led to resolution. There was no evidence of mediastinitis. At the 1-year follow-up, the patient remained well, with a centralised mediastinum without further evidence of infection of the postpneumonectomy space. This is to our knowledge the first reported case of chronic infection of a repositioned mediastinum in the context of postpneumonectomy syndrome.
肺切除术后综合征是肺切除术后一种罕见的并发症。通过将假体植入肺切除术后的间隙来重新定位纵隔可缓解症状。我们报告一例70岁出头的男性患者，在植入硅盐水假体以治疗肺切除术后综合征8年后出现坏死性脓胸。切除胸壁窦道、再次行右开胸手术并取出感染的硅盐水假体以及术后胸腔内冲洗后病情得到缓解。没有纵隔炎的证据。在1年的随访中，患者情况良好，纵隔居中，没有肺切除术后间隙进一步感染的证据。据我们所知，这是首例在肺切除术后综合征背景下重新定位纵隔发生慢性感染的病例报告。
