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Published on: October 25, 2024
Surgery for thoracic empyema: personal experience and current highlights.
Miguel Guerra1, Paulo C Neves, Daniel Martins
1Serviço de Cirurgia Cardiotorácica do Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal.
Summary
Thoracic empyema management requires early diagnosis and treatment. Treatment strategies for acute and chronic empyema vary, often involving surgical debridement or pleural space obliteration, with individualized approaches recommended.
Area of Science:
- Thoracic surgery
- Pulmonary medicine
Background:
- Thoracic empyema presents ongoing challenges in surgical practice.
- Effective management hinges on timely diagnosis and intervention.
Purpose of the Study:
- To outline current principles and strategies for treating thoracic empyema.
- To discuss decision-making factors and surgical options for acute and chronic empyema.
Main Methods:
- Review of established treatment paradigms for thoracic empyema.
- Discussion of surgical interventions including video-assisted thoracoscopic debridement, decortication, and thoracoplasty.
- Consideration of open-window thoracostomy for non-eligible patients.
Main Results:
- Treatment decisions for empyema are guided by etiology, patient condition, and disease stage.
- Video-assisted thoracoscopic debridement is recommended for acute empyema unresponsive to chest tube drainage.
- Radical treatments for chronic empyema include decortication or pleural space obliteration; open-window thoracostomy is an alternative.
Conclusions:
- Current thoracic empyema treatment concepts rely heavily on expert opinion.
- No single procedural sequence guarantees universally successful outcomes.
- Individualized treatment plans, based on institutional protocols, are recommended.
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