Background: The empyema space is refractory to elimination of bacterial colonization. Electrolyzed saline (ES) was used as intra-pleural irrigation for rapid disinfection of the empyema space.Patients and Methods: Twenty consecutive patients with para-pneumonic empyema were reviewed in this study from 2007 to 2015. The empyema space was irrigated by miniaturized thoracoscopic surgery (mini VATS), and the efficacy and safety of the use of ES were evaluated.Results: Sixteen patients were male and four were female, with a mean age of 66.5 ± 9.5 y (27–90 y). Bacterial cultures of the purulent effusions from all 20 patients had positive results. Seventeen patients subsequently underwent continuous catheter irrigation and drainage. No patient had chest pain during ES irrigation. Fever duration after mini VATS was 2.8 ± 1.8 d (0–5 d). Catheter indwelling time was 10.3 ± 7.2 d (3–33 d). Inflammatory markers significantly improved (p < 0.05) within a week after mini VATS. Eighteen patients achieved pleural disinfection, and two patients had residual pathogens, one of whom later died of lung abscess. Space closure was successful in 14 patients. No patient underwent subsequent open drainage. Nineteen (95%) patients were discharged from the hospital. This treatment was successful in 18 (90%) patients, and one (5.6%) patient experienced recurrence.Conclusions: The ES irrigation facilitates the rapid disinfection and closure of the empyema space.

Introduction: Acute empyema without bronchofistulae is now a well controllable disease by intrapleural irrigation with electrolyzed saline (ES), current ultimate disinfectant for biological tissues. ES irrigation was applied to postoperative empyema of esophagectomy, resulting hospital discharge without any surgical options. A 67 year old male with esophageal cancer had acute empyema in the right side, caused by anastomotic leaks, on postoperative day 7 after esophagectomy with neck lymphnode dissection reconstructed with gastric conduit through retrosternal route. He had catheter drainage with 2000 ml/day of ES irrigation for 20 days immediately after diagnosis of empyma. Pathogens were promptly eliminated, and empyema space was spontaneously closed. He had second empyema caused by gastric conduit rupture at the stapled line after 38 days of the cure in the first empyema. The patient had second ES irrigation under catheter indwell, and recovered for three weeks according to the spontaneous closure of the conduit leaks, and finally discharged our hospital after dilation of anastomotic stricture and swallowing rehabilitation. Conclusions: ES irrigation promptly controlled postoperative empyema of esophagectomy without surgical options for residual deadspace.

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In this study we report on two cases of amebic colitis treated in our hospital. On admission both patients were in a severe state of malnutrition due to intermittent diarrhea which had continued for one month. Both patients suffered from amebic colitis presumably transmitted by homosexual intercourse. A definite diagnosis of amebic colitis was made from both fecal examination and colonoscopic biopsy. After the diagnosis was made, the patients were treated with metronidazole. This medication can eliminate Entamoeba histolytica, although it was insufficient for the treatment of the patients’malnutrition. Therefore we used total parenteral nutrition to treat their malnutrition. It was successful and resulted in their recovery and discharge. These two cases indicate that total parenteral nutrition therapy is useful for supporting the recovery of patients with amebiasis.