Pneumonotomy: an alternative way for managing lung abscess.
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.
Lee
Chieh-Hung
CH
Division of Thoracic and Cardiovascular Surgery, Ten-Chen General Hospital, Taoyuan County, Taiwan.
Liu
Yun-Hen
YH
Lu
Ming Shian
MS
Hsieh
Ming-Ju
MJ
Wu
Yi-Cheng
YC
Ko
Po-Jen
PJ
Liu
Hui-Ping
HP
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