A new technique for one-stage radical eradication of long-standing chronic thoracic empyema

The surgical treatment of chronic long-standing thoracic empyema remains a challenging subject. A simple technique that consumes less operative time, accompanying less bleeding, and that enables eradication of the disease in one stage was devised by the senior author. The technique requires only three major steps: (1) decortication limited to the parietal sides of the peel's sac, (2) cleansing the empyemic cavity, and (3) drainage. To date, six patients have been treated by this method; complete cure was achieved in all. Neither death nor recurrence of the disease has been noted during the follow-up period averaging 24.5 months. The mean operative time was 3.06 hours, mean bleeding volume was 1262 ml, and the mean hospital stay period was 1.14 months. The methods and results of the technique are discussed.