Korean J Thorac Cardiovasc Surg.  2017 Jun;50(3):202-206. 10.5090/kjtcs.2017.50.3.202.

Early Aggressive Surgical Treatment of Multiloculated Empyema

• Baek JH
• Lee YU
• Lee SS
• Lee JH
• Lee JC
• Kim MS

• KMID: 2381904
• DOI: http://doi.org/10.5090/kjtcs.2017.50.3.202

Abstract

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.

Keyword

Empyema; Infection; Pleural disease

MeSH Terms

Abscess
Alcoholism
Diabetes Mellitus
Drainage
Emergencies
Empyema*
Exudates and Transudates
Humans
Incidence
Length of Stay
Lung Abscess
Pleural Diseases
Retrospective Studies