Postoperative preservation of pulmonary function in patients with chronic empyema thoracis: A one-stage operation

Nakaoka, Kazuya; Nakahara, K; Iioka, S; Mori, Takashi; Sawamura, K; Kawashima, Yasunaru

doi:10.1016/0003-4975(89)90017-9

Cited by 15 publications

(6 citation statements)

References 17 publications

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“…In case of the restricting fibrous peel over the underlying lung, most cases do not resolve without surgical treatment. Successful decortication requires complete removal of the thickened pleural peel to permit full pulmonary re‐expansion, while avoiding parenchymal injury 6,16,17 . We carried out 63 consecutive decortications in stage 3 pleural empyema, for although it is an extensive operation, it is currently believed to be the best treatment method available for this stage.…”

Section: Discussionmentioning

confidence: 99%

“…Successful decortication requires complete removal of the thickened pleural peel to permit full pulmonary re-expansion, while avoiding parenchymal injury. 6,16,17 We carried out 63 consecutive decortications in stage 3 pleural empyema, for although it is an extensive operation, it is currently believed to be the best treatment method available for this stage. In our patients, persistent air leak and residual spaces were the main problems, although in some cases pulmonary expansion completely filled the pleural space only on the first or second postoperative day.…”

Section: Discussionmentioning

confidence: 99%

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Spirometric Changes After Pleural Decortication in Young Adults

Gorur

Yıldızhan

Yiyit

et al. 2007

ANZ Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spirometric Changes After Pleural Decortication in Young Adults

Gorur

Yıldızhan

Yiyit

et al. 2007

ANZ Journal of Surgery

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“…Improved pulmonary function can be expected with this procedure. 40 The key to success is to keep the extraparietal space free from contamination.…”

Section: Air Plombagementioning

confidence: 99%

Surgical treatment of chronic empyema

Shiraishi

2010

Gen Thorac Cardiovasc Surg

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Empyema remains challenging for thoracic surgeons. This review covers diverse aspects of acute empyema and chronic empyema and its surgical treatment. The triphasic nature of thoracic empyema (stages I, II, and III) is also addressed. The principles of empyema treatment are early diagnosis and early treatment. For acute empyema (empyema in stages I and II), early surgical intervention, such as video-assisted thoracoscopic débridement, is recommended when conventional chest tube drainage has failed. Radical treatments of chronic empyema (empyema in stage III) include (1) removal of the empyema space (decortication with or without lung resection) and (2) obliteration of the pleural space with muscle flaps or omentum flaps, or by thoracoplasty. Decortication is the procedure of choice for patients with reexpandable underlying lung. When bronchopleural fistula exists in the underlying lung, the fistula should be securely closed. For those patients whose underlying lung cannot be expected to reexpand, the procedure of choice is either concomitant removal of the affected lung with the empyema space or obliteration of the pleural space. For patients who are not eligible for the above-mentioned radical treatment, open-window thoracostomy can be considered. This procedure is not only performed as a definitive treatment of empyema but also as a preparatory treatment for radical procedures. Radical procedures are performed when patients recuperate. Choosing the most suitable operation based on the stages of empyema, the conditions of the underlying lung, and the conditions of a patient holds the key to success.

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“…The rest had unclosed pleural space and underwent collapse of the parietal wall without rib resection, with good response and preservation of pulmonary function. 125 Ali and associates treated 47 patients with massive tuberculous empyema and collapsed and entrapped lung with open drainage, modified Eloesser procedure, and pleural window. Twenty-eight patients (59%) had completely reexpanded underlying lung between 4 and 30 months after the procedure, whereas eight (17%) developed lung destruction with fibrosis, bronchiectasis, and pleural adhesions.…”

Section: Tuberculous Empyemamentioning

confidence: 99%

Tuberculous Pleural Effusion and Tuberculous Empyema

Ferrer

2001

Seminars in Respiratory and Critical Care Medicine

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Tuberculous pleuritis has increased worldwide, especially in developing countries, as a consequence of human immunodeficiency virus co-infection. Tuberculous pleuritis is a delayed hypersensitivity reaction against mycobacterial antigens in the pleural space. Mycobacteria are detected in less than 50% of pleural samples, but the characteristic pleural involvement, granulomas with or without caseous necrosis, is evident in 56 to 80% of cases from samples obtained by percutaneous pleural biopsy. Of several pleural fluid parameters studied, adenosine deaminase and interferon gamma (IFN-gamma) have the best diagnostic yield, while polymerase chain reaction remains a promising test. Treatment of patients with tuberculous pleuritis is discussed. Tuberculous empyema is a rare form of tuberculous pleuritis. It consists of a purulent infection of the pleural cavity with detectable bacilli in pleural fluid. Diagnosis is easily established clinically and bacteriologically. Treatment is to adequately drain the pleural space and achieve lung reexpansion, in conjunction with antituberculous chemotherapy. The efficacy of different surgical techniques is discussed.

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Postoperative preservation of pulmonary function in patients with chronic empyema thoracis: A one-stage operation

Cited by 15 publications

References 17 publications

Spirometric Changes After Pleural Decortication in Young Adults

Spirometric Changes After Pleural Decortication in Young Adults

Surgical treatment of chronic empyema

Tuberculous Pleural Effusion and Tuberculous Empyema

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