[Results of treatment for chronic pleural empyema]

The aim of the study was to assess the results of the treatment in 97 patients with chronic pleural empyema treated in the department of thoracic surgery between 1988 and 1997. The majority of patients were between 30 and 50 years old. Most of the group were men and more than a half had a concomitant disease, which may predispose to empyema development. Nevertheless all the empyemas were in the chronic phase 1/3 of patients were successfully treated only with closed chest tube drainage and the remaining group with lung decortication. The Gram-negative bacterial flora dominated in the culture from empyema sac. Spirometric values and blood gas analysis showed significant reduction of lung function before the treatment. We found the relation between an early institution of closed tube drainage and the shorter stay at the hospital. Moreover in a significant proportion of patients pleural drainage was a sufficient way of treatment.

Drainage of the empyema should be performed at early phase of the disease. It should be recommended that pleural drainage precede the surgical management of empyema. Delate of surgical intervention is the main cause of the high mortality rate in empyema following esophageal perforation.