title: Pneumonotomy: an alternative way for managing lung abscess.
abstract: BACKGROUND
  Surgical resection (SR) is the most effective strategy in the management of patient with lung abscess who have failed medical treatment. Surgical drainage (SD) of lung abscess is an alternative in high-risk patients. There are limited findings in comparing the two procedures. The aim of this study was to compare surgical outcomes in patients who underwent SR versus SD.
  
  
  METHODS
  We retrospectively reviewed 61 patients receiving surgical intervention for lung abscess in our hospital from 1994 to 2002. The patients were divided into two groups according to different surgical procedure. They are patients who received SR (lobectomy, pneumonectomy or wedge resection) and patients who underwent SD (pneumonotomy) of lung abscess.
  
  
  RESULTS
  There were 33 patients enrolled in SD and 28 patients in the SR for lung abscess. There was no significant difference between the two groups in number of risk factors or size or location of abscess. The operation time and blood loss seemed to be less in SD, although they did not reach statistic difference. Postoperative major complications were more frequent for SD than for SR (36.3 vs 32.1%, P = 0.038). The mortality rate and total complication rate were similar.
  
  
  CONCLUSIONS
  When surgery is indicated for lung abscess, SR is the preferred procedure. Whenever there are great difficulties during SR or patients are unable to tolerate major pulmonary resection, SD can be an alternative choice. The techniques were relatively easy and effective. The surgical outcomes in short term was favourable and can be comparable to that of standard SR.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Ten-Chen General Hospital, Taoyuan County, Taiwan.
authors.forename: Chieh-Hung
authors.initials: CH
authors.lastname: Lee
authors.forename: Yun-Hen
authors.initials: YH
authors.lastname: Liu
authors.forename: Ming Shian
authors.initials: MS
authors.lastname: Lu
authors.forename: Ming-Ju
authors.initials: MJ
authors.lastname: Hsieh
authors.forename: Yi-Cheng
authors.initials: YC
authors.lastname: Wu
authors.forename: Po-Jen
authors.initials: PJ
authors.lastname: Ko
authors.forename: Hui-Ping
authors.initials: HP
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000188:drug therapy; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008169:Lung Abscess / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome