Thoracic empyema is defined as purulent pleural effusion or effusion with positive bacteriology. Recently, the empyema has markedly decreased by development of antibiotics, but empyemas following thoracotomy were occasionaly reported.
During the period of January, 1985 to May, 1991, 18 patients with postthoracotomy empyema have been treated in the Department of Thoracic and Cardiovascular Surgery of Chonbuk National University Hospital.
There were 17 males and 1 female ranged from 18 years to 67 years of age. The underlying diseases of empyema were tuberculosis(50%),lung cancer(33.3%), esophageal cancer(11.1%), and aspergillosis with tuberculosis(5.6%).
In surgical procedures causing the empyema, there were lobectomy(38.9%), pneumonectomy(22.2%), decortication(16.7%), decortication & lobectomy(11.1%), and esophagectomy(11.1%). Etiologic organisms in the pleural fluid were Pseudomonas(27.7%), S,
aureus(16.7%0, mixed infection(16.7%), K. pneumonia(5.6%), M. tuberculosis(5.6%), and no isolation(27.7%).
In 6 cases with BPF, completion pneumonectomy was performed in 1 case, and open thoracostomy in 5 cases. In 12 cases without BPF, closed thoracostomy was performed in 1 cases, decortication in 2 cases, decortication &open thoracostomy in 2 cases,
and
open thoracostomy in 7 cases.
In 6 cases with BPF, the fistulas were closed in 4 cases at follow up, the other 2 cases died from pulmonary insufficiency after completion pneumonectomy and open thoracostomy, respectively. In 12 cases without BPF, the empyema cavities were
filled
with
expanded lungs and granulation tissues, except 1 cases died from sepsis. (Korean J Thoracic Cardiovas Surg 1993;26:769-74)
|