TITLE

Surgical Treatment of Pleural Empyema According to Disease Stage

AUTHOR(S)
Pilav, Ilijaz; Guska, Safet; Musanovic, Safet; Kadric, Kenan
PUB. DATE
December 2009
SOURCE
Medicinski Arhiv;2009, Vol. 63 Issue 5, p295
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Para pneumonic effusions are often complications of bacterial pneumonia, occurring in 5-50% patients and in 15% cases it can progress into pleural empyema. Pleural empyema treatment includes drainage of pus, re-expansion of lung by using appropriate antibiotics. Surgical treatment covers implementation of certain thoracic drainage modifications, use of VATS techniques and thoracotomy with pleura decortications. PATIENTS: Research has involved 100 patients with diagnosis and treatment of para pneumonic and meta pneumonic pleural empyema. RESULTS: Based on previously defined phase of pleural empyema it was determined which surgical procedures have been used in definitive treatment of pleural empyema. In case of 31,17% (24/77) patients it has been found that pre-clinical treatment lasted 31 days and longer, and 49,35%(38/77) patients have been admitted at Clinic after 11 to 30 days of pre-clinic treatment. Only in 19.48% (15/77) patients pre-clinic treatment lasted up to 10 days. 79% (79/100) patients were in third phase of disease, 19% (19/100) patients were in second phase and 2% (2/100) patients were in first stage of disease. Among patients with first stage of disease 1 patient was subject to pleural drainage and 1 was subject to decortications. Among patients with second phase of disease 10 patients were subject to pleural drainage and 9 to decortications. Among patients with third phase of disease 20 patients were subject to pleural drainage and 49 to decortications, 4 patients were subject to pleural drainage with rib resection, and 2 were subject to combination of thoracoscopy and drainage, while in case of 4 patients it was necessary to perform additional drainage. CONCLUSIONS: Pleural drainage is first procedure in surgical treatment of pleural empyema, but very often it is not definitive measure of treatment of patients with third phase of disease. Definitive treatment of empyema in third phase is decortications of pleura carried out on 62% patients with this phase of disease. Efficiency of treatment determined on basis of mortality level is satisfactory.
ACCESSION #
47436254

 

Related Articles

  • Empyema thoracis: Controversies and technical hints. Raveenthiran, V. // Journal of Indian Association of Pediatric Surgeons;Jul-Sep2005, Vol. 10 Issue 3, p191 

    This communication is the summary of Internet discussions held by members of the Indian Association of Pediatric Surgeons (IAPS) in June 2005. It reflects the opinion and practice of Indian pediatric surgeons on the treatment of childhood empyema thoracis (ET). Despite the availability of...

  • LATE SPONTANEOUS CHEST WALL BLEEDING AFTER OPEN THORACIC WINDOW FOR EMPYEMA. BOȚIANU, PETRE VLAH-HOREA; BOȚIANU, ALEXANDRU MIHAIL // Acta Medica Transilvanica;dec2013, Vol. 18 Issue 4, p234 

    We report a 47-year-old male referred to our unit for a pleural empyema, with no response to antibiotic treatment and drainage, who underwent a thoracomyoplasty. Due to the recurrence of the empyema we have performed a modified open thoracic window (OTW) through re-opening of the operative...

  • Complex pleural empyema can be safely treated with vacuum-assisted closure.  // Journal of Cardiothoracic Surgery;2011, Vol. 6 Issue 1, p130 

    The article presents a study which found that complex pleural empyema can be safely treated with vacuum-assisted closure. The study investigated eight patients with multimorbidity, treated for a postoperative or recurrent pleural empyema between October 2009 and July 2010. Of 414 operated...

  • NON-TUBERCULOUS PLEURAL EMPYEMA -- RETROSPECTIVE STUDY, AUGUST 2007-AUGUST 2012 WITHIN THE THORACIC SURGERY DEPARTMENT BELONGING TO THE PNEUMO-PHTISIOLOGY HOSPITAL "LEON DANIELLO" IN CLUJ-NAPOCA. GOIA, ANGELA // Clujul Medical;2013 Supplement, pS48 

    Background. Empyema is defined as the presence of pus within pleural cavity and is accompanied by a substantial morbidity and mortality. Aim, Methods. This is a retrospective study of the cases of non-tuberculous pleural empyema, hospitalized and treated in the last 5 years and it research the...

  • Management of empyema -- Role of a surgeon. Gupta, D. K.; Sharma, Shilpa // Journal of Indian Association of Pediatric Surgeons;Jul-Sep2005, Vol. 10 Issue 3, p142 

    Postpneumonic empyema still remains quite common in developing countries, especially during the hot and humid months. While most cases would respond to antibiotic therapy, needle aspiration and intercostal drainage, few cases require further surgical management. The most common nontubercular...

  • HEMORAGIE SPONTANÄ‚ TARDIVÄ‚ DIN PERETELE TORACIC DUPÄ‚ FEREASTRÄ‚ PLEURALÄ‚ PENTRU EMPIEM. BOȚIANU, PETRE VLAH-HOREA; BOȚIANU, ALEXANDRU MIHAIL // Acta Medica Transilvanica;dec2013, Vol. 18 Issue 4, p73 

    We report a 47-year-old male referred to our unit for a pleural empyema, with no response to antibiotic treatment and drainage, who underwent a thoracomyoplasty. Due to the recurrence of the empyema we have performed a modified open thoracic window (OTW) through re-opening of the operative...

  • Spontaneous Chest Wall Interstitial Emphysema Secondary to Chronic Empyema Thoracis. BHAT, VENKATRAMAN S.; POOJARAMUDDANAHALLI, MANJUNATH; RAJAGOPALAN, NATARAJAN; GADABANAHALLI, KARTHIK // Journal of Clinical & Diagnostic Research;Jun2015, Vol. 9 Issue 6, p5 

    Spontaneous extension of air from the pleural space to the chest wall, also referred to as pneumothorax necessitans (PN), is a rare occurrence. Few of such cases have been reported in the literature, some appear to have a pattern of extension from pleural cavity to chest wall. Clinical...

  • Outcome of patients with nonspecific pleuritis/fibrosis on thoracoscopic pleural biopsies Davies, Helen E.; Nicholson, Jennie E.; Rahman, Najib M.; Wilkinson, Emily M.; Davies, Robert J.O.; Lee, Yun Chor Gary // European Journal of Cardio-Thoracic Surgery;Oct2010, Vol. 38 Issue 4, p472 

    Abstract: Objective: Medical thoracoscopy is recommended in the investigation of patients with exudative pleural effusions, especially when pleural fluid analysis is uninformative. The histological finding of ‘nonspecific pleuritis/fibrosis’ is common in thoracoscopic biopsies and...

  • Editorial comments. Gupta, D. K. // Journal of Indian Association of Pediatric Surgeons;Jul-Sep2005, Vol. 10 Issue 3, p194 

    Reports on the decision of the "Journal of the Indian Association of Pediatric Surgeons" (JIAPS) to incorporate the consolidated view point of the IAPS yahoo group member on the management of empyema.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics