[Technic, indications and value of pulmonary decortications (615 operated cases)]

On the basis of their experience in 615 cases of pleuropulmonary decortication, the authors discuss the indications, contraindications, approach and procedure in pleuropulmonary decortication. Surgery has the double purpose of suppressing the empyema cavity and recovering most of the functional pulmonary parenchyma. A personal procedure was applied consisting of thoracotomy through the sixth intercostal space, then along the cleavage lines outside the limits of the empyema pouch, from the periphery towards the center at the level of the pulsatile organs, zones called the key points of pleuropulmonary decortication. Very good results were obtained in 80--50% of the tuberculous empyema cases and in 90--95% of the non-tuberculous diseases. The authors consider that pleuropulmonary decortication is a widely applicable surgical method in pleural empyema, being one of the few surgical methods used for redressing the function of an organ.