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Early Aggressive Surgical Treatment of Multiloculated Empyema
Jong Hyun Baek1, Young Uk Lee1, Seok Soo Lee1
1Department of Thoracic and Cardiovascular Surgery, Yeungnam University College of Medicine.
Background:
Empyema is the collection of purulent exudate within the pleural space. Overall, 36%-65% of patients with empyema cannot be treated by medical therapy alone and require surgery. Multiloculated empyema is particularly difficult to treat with percutaneous drainage. Therefore, we describe our experiences with early aggressive surgical treatment for rapid progressive multiloculated empyema.
Methods:
From January 2001 to October 2015, we retrospectively reviewed 149 patients diagnosed with empyema who received surgery. The patients were divided into 2 groups according to whether they underwent emergency surgery or not. We then compared surgical outcomes between these groups.
Results:
The patients in group A (emergency surgery, n=102) showed a more severe infectious state, but a lower complication rate and shorter length of hospital stay. The incidence of lung abscess was higher in group A, and abscesses were associated with diabetes and severe alcoholism.
Conclusion:
Early aggressive surgical treatment resulted in good surgical outcomes for patients with rapid progressive multiloculated empyema. Furthermore, we suspect that the most likely causes of multiloculated empyema are lung abscesses found in patients with diabetes mellitus as well as severe alcoholism.
Insights
Early aggressive surgery for multiloculated empyema (pus in the pleural space) improves outcomes. This approach led to fewer complications and shorter hospital stays in patients with severe infections.
Area of Science:
- Thoracic Surgery
- Infectious Diseases
- Pulmonology
Background:
- Empyema involves pus accumulation in the pleural space, often requiring surgical intervention.
- Multiloculated empyema presents challenges for percutaneous drainage, necessitating alternative treatments.
- 36%-65% of empyema cases require surgery beyond medical therapy.
Purpose of the Study:
- To evaluate the efficacy of early aggressive surgical treatment for rapid progressive multiloculated empyema.
- To compare surgical outcomes between patients undergoing emergency versus non-emergency surgery for empyema.
Main Methods:
- Retrospective review of 149 patients with empyema who underwent surgery between January 2001 and October 2015.
- Patients were categorized into emergency surgery (Group A) and non-emergency surgery groups.
- Surgical outcomes were compared between the two groups.
Main Results:
- Emergency surgery (Group A, n=102) patients presented with more severe infections but experienced lower complication rates and shorter hospital stays.
- The incidence of lung abscess was higher in the emergency surgery group.
- Lung abscesses were found to be associated with diabetes and severe alcoholism.
Conclusions:
- Early aggressive surgical intervention yields favorable outcomes for patients with rapid progressive multiloculated empyema.
- Lung abscesses in patients with diabetes mellitus and severe alcoholism are suspected causes of multiloculated empyema.
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