Postoperative Empyema: Etiology, Prevention and Treatment

¹ The Department of Surgery, Church Home and Hospital.

1. The extent of pulmonary resection determines the mortality, morbidity, and postoperative complication. Therefore, careful distinction should be made between pneumonectomy, lobectomy, and segmental resection.

2. The principle of a fully expanded lung and an empty or obliterated pleural space can be accomplished after lobectomy and segmental resection. The principle cannot be applied after pneumonectomy. Accordingly, a more meticulous sterile technic must be carried out after pneumonectomy.

3. Postoperative pleural empyema must be divided into those groups occurring after (a) pneumonectomy and (b) where less than a pneumonectomy was done. These two divisions must be further subdivided into (a) those with bronchopleural fistula and (b) those without bronchopleural fistula.

4. The best method of treatment for empyema is prevention. Means to accomplish this are described.

5. The treatment of empyema can be divided into (a) aspiration and sterilization by needle or closed thoracotomy tube method, and (b) open or closed drainage followed by thoracoplasty when needed.