Early thoracoscopic debridement and drainage as definite treatment for pleural empyema.
OBJECTIVE
To report our experience with early thoracoscopic debridement and drainage in the treatment of pleural empyema in the fibrinopurulent or early organising phase.


METHODS
Prospective open study.


METHODS
District hospital, Germany.


METHODS
10 Patients operated on between August 1991 and April 1993.


METHODS
Double lumen intubation, followed by thoracoscopic opening of the empyema, evacuation of all pus under vision, debridement of the lung, irrigation of the thoracic cavity and insertion of a chest drain.


METHODS
Morbidity and mortality.


RESULTS
Cultures taken during the operation grew no pathogens in five cases; Streptococcus pneumoniae, and haemolytic streptococci (once in combination with Staphylococcus aureus), were cultured in two cases each; and Mycobacterium tuberculosis in one. Chest drains were removed a mean of 8.5 days after operation. All patients were well without signs of infection 1-21 months later, and in no case was conversion to open operation necessary.


CONCLUSIONS
Early thoracoscopic debridement and drainage is a safe and effective alternative to open treatment of patients with pleural empyema in the fibrinopurulent or early organising phase.
Sendt
W
W
Department of General, Thoracic and Vascular Surgery, Nordwest-Krankenhaus Sanderbusch, Sande, Germany.
Förster
E
E
Hau
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003646:Debridement; D004322:Drainage; D016724:Empyema, Pleural / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D004654:Empyema, Tuberculous / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000628:therapy; D013290:Streptococcal Infections / Q000175:diagnosis / Q000628:therapy; D013492:Suppuration; D013906:Thoracoscopy; D013997:Time Factors; D014057:Tomography, X-Ray Computed