Use of sulfur hexafluoride, SF6, in the management of the postpneumonectomy pleural space.

After a pneumonectomy in patients of advanced age with lung cancer, overinflation of the contralateral lung causes a further emphysematous change. This aggravation of emphysematous disturbances occasionally leads to serious cardiopulmonary dysfunctions. Therefore, we have devised a new therapeutic method which consists in injecting sulfur hexafluoride, SF6, an inert gas, into the postpneumonectomy pleural space so as to maintain the chest cavity. As SF6 gas is slowly absorbed through the pleura, gas injection at intervals of 6 months can maintain a clear pleural space with neither retention of pleural effusion nor deformity of the thorax. As a result, in 23 patients who were treated by this method, overinflation of the contralateral lung after unilateral pneumonectomy could be prevented, and respiratory functions could be improved, i.e., the vital capacity increased about 20% and the residual volume decreased over 20% after SF6 gas injection. All patients have been in good condition of their performance status, and it was not disadvantageous to continue the SF6 gas injection for a long term such as several years.