Title:Empyema and Bronchopleural Fistula Following Lung Resection
VOLUME: 8 ISSUE: 4
Author(s):Alan A. Simeone
Affiliation:Division of Cardiac Surgery, The Johns Hopkins Hospital, Sheikh Zayed Tower, Suite 7107, 1800 Orleans Street, Baltimore, MD 21287, USA.
Keywords:Bronchopleural fistula, empyema, lobectomy, pneumonectomy, thoracic surgery complications, Lung Resection, pleural space, Post-resection, anesthetic management, BPF.
Abstract:Formal resectional surgery for benign and malignant diseases of the lungs was one of the last frontiers to be
explored and mastered within the broad specialty of surgery. This was the result of the unique physiological properties of
the pleural space and the mechanics of respiration. Additional obstacles included the requirement for refined anesthesia,
surgical techniques and equipment in order to allow successful control of the airway and vasculature. Despite impressive
and ongoing improvement in operative technique, anesthetic management, patient selection and perioperative care, the
complexities unique to the airway, pleural space and rigid chest wall continue to make pulmonary resection a challenging
undertaking. Post-resection bronchopleural fistula and post-resection empyema, while relatively uncommon, remain
perhaps the most morbid and difficult complications encountered in thoracic surgery. Understanding of and adherence to
basic principles of management as well as the thoughtful application of innovative therapies have resulted in improved
outcomes when these dreaded complications occur.
