Advertisement

Source Control pp 201-206 | Cite as

Pleural Empyema

  • T. Hau
  • E. Förster
Chapter
  • 126 Downloads

Abstract

• Pleural empyema can be divided into three phases: a) Exudative b) Fibrinopurulent c) Organizing • Pleural empyema may be: a) Para- or postpneumonic b) Postoperative c) Posttraumatic d) Secondary to other intrathoracic or upper abdominal infections • Primary management of para- or postpneumonic empyemas is with antibiotics. Source control is a secondary measure whose aims are the evacuation of pus and full expansion of the lung; approaches to source control must be adapted to the stage of the disease. • The objective of source control in postresectional empyema is to close any bronchopleural fistula and reexpand the lung, or, after pneumectomy,to stabilize or obliterate the thoracic space.

Keywords

Pleural Fluid Muscle Flap Source Control Tube Thoracostomy Bronchopleural Fistula 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    American Thoracic Society (1962) Management of non-tuberculous empyema. Am Rev Respir Dis 85:935–936 This is a statement of the Subcommittee on Surgery of the American Drug Society about the management of non-tuberculous empyema, defining the classical phases of pleural empyema.Google Scholar
  2. 2.
    Yeh TJ, Hall DP, Ellison RG (1963) Empyema thoracis: a review of 110 cases. Am Rev Respir Dis 88:785–790PubMedGoogle Scholar
  3. 3.
    Snider, GL, Saleh, SS (1968) Empyema of the thorax in adults: review of 105 cases. Dis Chest 54:12–17Google Scholar
  4. 4.
    Vianna NJ (1971) Nontuberculous bacterial empyema in patients with and without underlying disease. JAMA 215: 69–75 These two papers present large series of patients with pleural empyema. In addition to therapeutic guidelines they give a good overview of the etiology and bacteriology of the disease.PubMedCrossRefGoogle Scholar
  5. 5.
    Light RW (1992) Management of empyema. Sem Respir Med 13167-176 A good overview of the management, but also of the clinical manifestations and the diagnosis, of empyema.Google Scholar
  6. 6.
    Mandal AK, Thadepalli H (1987) Treatment of spontaneous bacterial empyema thoracis. J. Thorac Cardiovasc Surg 94:414–418 An outline of the antibiotic as well as the surgical treatment of para-and postpneumonec-tomy empyema.PubMedGoogle Scholar
  7. 7.
    Sendt W, Förster E, Hau T (1995) Early thoracoscopic debridement and drainage as definite treatment for pleural empyema. Eur J Surg 161:73–76 This is one of the first papers showing that thoracoscopic treatment of phase II empyema is feasible and yields satisfactory results.PubMedGoogle Scholar
  8. 8.
    Cassina PC, Hauser M, Hillejan et al (1999) Video-assisted thoracoscopy in the treatment of pleural empyema: stage based management and outcome. J Thorac Cardiovasc Surg 117:234–238 A large series of patients with stage II and stage III empyema treated with video-assisted thoracoscopic debridement.PubMedCrossRefGoogle Scholar
  9. 9.
    Wait MA, Sharma S, Hohn J, Dal Nogoe A (1997) A randomized trial of empyema therapy. Chest 111:1548–1551 A randomized trial of empyema therapy showing that primary treatment with video-assisted thoracoscopic surgery is more efficient than local fibrinolytic therapy.PubMedCrossRefGoogle Scholar
  10. 10.
    Eloesser L (1935) An operation for tuberculous empyema. Surg Gynecol Obstret 60:1096–2000 This classic paper describes the use of a skin flap in the treatment of stage III empyema.Google Scholar
  11. 11.
    Samson PC (1971) Empyema thoracis: essentials of present day management. Ann Thorac Surg 11:210–221 An overview of the treatment of empyema. including the indication and technique of open tube thoracostomy and decortication.PubMedCrossRefGoogle Scholar
  12. 12.
    Pezzella A, Adebonoja SA, Hooker SG, Mabogunje OA, Conlan AA (2000) Complications of general thoracic surgery. Curr Probl Surg 37:742–858 This short monograph gives an overview over the complications of general thoracic surgery including the space problems and pleural infections after lobectomy and pneumonectomy.CrossRefGoogle Scholar
  13. 13.
    Clagett OT, Geraci JE (1962) A procedure for the management of postpneumonectomy empyema. J Thoracic and Cardiovasc Surg 45:141–145 This is about the sterilization of the thoracic cavity in postpneumonectomy empyema by antibiotic irrigation.Google Scholar
  14. 14.
    Baldwin JC, Mark JBD (1985) Treatment of bronchopleural fistula after pneumonectomy. J Thorac Cardiovasc Surg 90:813–817 Transpericardial closure of the bronchial stump with a stapling device is advocated in patients with a chronic broncho-pleural fistula after pneumonectomy.PubMedGoogle Scholar
  15. 15.
    Miller JI, Mansour KA, Nahai F, Jurkiewicz MJ, Hatcher CR Jr (1984) Single-stage complete muscle flap closure of the postpneumonectomy empyema space: a new method and possible solution to a disturbing complication. Ann Thorac Surg 38:227–231 This classical paper describes the obliteration of a postpneumonectomy space in a single-stage transposition of multiple muscle flaps.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • T. Hau
  • E. Förster

There are no affiliations available

Personalised recommendations