Medicina 2002; 38 (supplement 2): 85-87
Empyemectomy-treatment of pleural empyema
Algis Kybartas, Vygantas Gruslys, Gintaras Kiškis, Arūnas Žilinskas, Jonas Narbutas, Vytautas Jovaišas, Irena Liubertienė, Ričardas Janilionis
Clinic of General Thoracic Surgery, Vilnius University, Lithuania
Key words: pleural empyema, empyemectomy.
Summary. Empyema thoracis has been recognized as a disease entity since the time of Hippocrates and historically has been associated with high mortality. Over 30 years ago, the American Thoracic Society described three stages in the natural course of empyema, namely the exudative, fibrinopurulent, and organizing phases. Decortication and suction drainage usually result in lung re-expansion, otherwise pleurocutaneous window, intrathoracic transposition of skeletal muscle, or thoracoplasty remain life-saving but now uncommon options for treating a closed-space infection.
During last 9 years (1993–2001) 50 patients underwent empyemectomy due to pleural empyema. Three patients died (6%). In 4 cases we had complications-hydropneumothorax.They received punction (3 patients) and 1 received tube toracostomy. In one case urgent retoracotomy was performed due to acute intrapleural bleeding. After successful empyemectomy 47 patients stay at hospital 14 days approximately.
Cor
respondence to A. Kybartas, Clinic of General Thoracic Surgery, Vilnius University, Žygimantų 3, Vilnius, Lithuania. E-mail: a.kybartas@takas.ltReceived 16 September 2002, accepted 25 October 2002