[Thoracoabscessotomy in combined treatment of lung gangrene]

Patients with gangrene and gangrenous abscess of the lung belong to the most severe group of patients with purulent lung diseases. Conservative treatment is not effective, lethality after lung resection or pneumonectomy ranges from 20 to 70%, therefore the study of less traumatic but life-saving operations is topical. From 1996 to 1998, 296 patients with purulent destructive processes in the lung were hospitalized, 34 of them had gangrene or gangrenous abscess of the lung with significant intoxication. Thoracoabscessostomy by original method with consecutive necrectomies, sanitation of purulent cavity was performed in 27 patients. After operation 2 patients died, 25 patients were discharged with clinical recovery in satisfactory conditions, with dry cavity in the lung. In remote terms the cavities are cicatrized or transform to spurious cysts. Indications for thoracoabscessostomy are formulated. It is method of choice in the treatment of patients with gangrenous lung abscess, when conservative treatment is not effective, but the risk of radical operation is very high.