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Chest, Vol 90, 511-515, Copyright © 1986 by American College of Chest Physicians

ARTICLES

Reappraisal of empyema thoracis. Surgical intervention when the duration of illness is unknown

EL Hoover, HK Hsu, MJ Ross, AM Gross, H Webb, A Ketosugbo and P Finch

The timing of surgical treatment of empyema remains controversial. Traditionally, thoracotomy is performed either within three weeks of diagnosis or delayed until presumed pleurodesis occurs. Often, these patients are moribund and the duration of illness impossible to determine. We report our surgical results in seven patients with a deteriorating clinical course and multiple loculations which persisted after tube thoracostomy and would not have responded to multiple thoracostomies. Five patients required decortication. One required lobectomy for an abscess which developed on the contralateral side six weeks after discharge. There were no deaths or recurrences of empyema. Average times from surgery to tube removal and to discharge were six to 12 days, respectively. We conclude that one can safely and cost- effectively treat these patients surgically even when the duration of illness and presence of pleurodesis are unknown, and that the postoperative course will be uncomplicated.


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S.-P. Luh, M.-C. Chou, L.-S. Wang, J.-Y. Chen, and T.-P. Tsai
Video-Assisted Thoracoscopic Surgery in the Treatment of Complicated Parapneumonic Effusions or Empyemas: Outcome of 234 Patients
Chest, April 1, 2005; 127(4): 1427 - 1432.
[Abstract] [Full Text] [PDF]


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Copyright © 1986 by the American College of Chest Physicians.