[Treatment of chronic empyemas in the pleural cavity]

The authors present the results of surgical treatment of chronic empyemas of the pleural cavity in 294 patients treated at the Surgical Department in the years 1980-1992. The methods of treatment are discussed taking in consideration the etiology of the empyemas, clinical presentation, coexistent diseases. In 86 patients (29.3%) decortication with partial resection of the lung was carried out (most often a lobe), in 123 patients (41.8%) a decortication was performed, in 8 (2.7%) thoracoplasty, in the remaining 41 (13.9%) drainage of the pleural cavity was carried out. Out of the 245 subjects treated surgically 3 (1.2%) died; in the remaining patients a full recovery was noted. A full recovery was noted in 22 (53.7%) out of the 41 treated with pleural cavity drainage. Eight patients with esophageal-pleural fistulas in the course of a advanced esophageal cancer died due to advanced malignancy. 11 were discharged with chronic drainage. The latter could not be treated surgically due to a existence of high risk factors.