Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Early Aggressive Surgical Treatment of Multiloculated Empyema

  • Baek, Jong Hyun (Department of Thoracic and Cardiovascular Surgery, Yeungnam University College of Medicine) ;
  • Lee, Young Uk (Department of Thoracic and Cardiovascular Surgery, Yeungnam University College of Medicine) ;
  • Lee, Seok Soo (Department of Thoracic and Cardiovascular Surgery, Yeungnam University College of Medicine) ;
  • Lee, Jang Hoon (Department of Thoracic and Cardiovascular Surgery, Yeungnam University College of Medicine) ;
  • Lee, Jung Cheul (Department of Thoracic and Cardiovascular Surgery, Yeungnam University College of Medicine) ;
  • Kim, Myeong Su (Department of Thoracic and Cardiovascular Surgery, Yeungnam University College of Medicine)
  • Received : 2016.08.31
  • Accepted : 2016.11.07
  • Published : 2017.06.05
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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.

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