caa a22 4500 47575218X CHVBK 20180406123527.0 cr unu---uuuuu 170329e20000601xx s 000 0 eng 10.1007/s005950070116 doi (NATIONALLICENCE)springer-10.1007/s005950070116 Surgical treatment for chronic pleural empyema [Elektronische Daten] [Morihito Okada, Noriaki Tsubota, Masahiro Yoshimura, Yoshifumi Miyamoto, Hiroyuki Yamagishi, Shinsuke Satake] Various surgical procedures have been developed in an attempt to alleviate the significant problems caused by chronic pleural empyema. The present study evaluates our 11-year experience of employing a number of therapeutic approaches for chronic empyema. Between 1987 and 1997, 45 consecutive patients underwent treatment for chronic empyema at our hospitals. They comprised 21 patients (47%) presenting with post-tuberculosis, 11 (24%) receiving cancer therapy including pulmonary resection, and 13 (29%) with postpneumonic empyema. Omentopexy, lung resection, and thoracoscopic surgery were performed in 10 (22%), 5 (11%), and 4 (9%) patients, respectively. Poor results of treatment were observed in two of the patients with post-tuberculous empyema, and three of the patients treated for cancer died of recurrence. The other 40 patients remain symptom-free. An improvement in quality of postoperative life was revealed by the exercise test rather than by static spirometry. Optimal therapy for chronic empyema requires selection of the most appropriate first and staged procedures for each patient. Moreover, lung resection should be minimal. In a critical state, open thoracostomy must be performed as the first procedure, while omentopexy or thoracoplasty should be restricted to selected cases. Dead space and minor air leakage may safely be left behind. A video-assisted procedure can be selected for postpneumonia empyema. Springer-Verlag, 2000 chronic empyema nationallicence thoracostomy nationallicence omentopexy nationallicence video-assisted surgery nationallicence Okada Morihito Department of Thoracic Surgery, National Hyogo Central Hospital, 1314 Ohara, 669-1515, Sanda, Hyogo, Japan aut Tsubota Noriaki Department of Thoracic Surgery, Hyogo Medical Center for Adults, 13-70 Kitaohji-cho, 673-0021, Akashi, Hyogo, Japan aut Yoshimura Masahiro Department of Thoracic Surgery, Hyogo Medical Center for Adults, 13-70 Kitaohji-cho, 673-0021, Akashi, Hyogo, Japan aut Miyamoto Yoshifumi Department of Thoracic Surgery, Hyogo Medical Center for Adults, 13-70 Kitaohji-cho, 673-0021, Akashi, Hyogo, Japan aut Yamagishi Hiroyuki Department of Thoracic Surgery, National Hyogo Central Hospital, 1314 Ohara, 669-1515, Sanda, Hyogo, Japan aut Satake Shinsuke Department of Thoracic Surgery, National Hyogo Central Hospital, 1314 Ohara, 669-1515, Sanda, Hyogo, Japan aut Surgery Today Springer-Verlag 30/6(2000-06-01), 506-510 0941-1291 30:6<506 2000 30 595 https://doi.org/10.1007/s005950070116 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s005950070116 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Okada Morihito Department of Thoracic Surgery, National Hyogo Central Hospital, 1314 Ohara, 669-1515, Sanda, Hyogo, Japan aut NATIONALLICENCE 700 1- Tsubota Noriaki Department of Thoracic Surgery, Hyogo Medical Center for Adults, 13-70 Kitaohji-cho, 673-0021, Akashi, Hyogo, Japan aut NATIONALLICENCE 700 1- Yoshimura Masahiro Department of Thoracic Surgery, Hyogo Medical Center for Adults, 13-70 Kitaohji-cho, 673-0021, Akashi, Hyogo, Japan aut NATIONALLICENCE 700 1- Miyamoto Yoshifumi Department of Thoracic Surgery, Hyogo Medical Center for Adults, 13-70 Kitaohji-cho, 673-0021, Akashi, Hyogo, Japan aut NATIONALLICENCE 700 1- Yamagishi Hiroyuki Department of Thoracic Surgery, National Hyogo Central Hospital, 1314 Ohara, 669-1515, Sanda, Hyogo, Japan aut NATIONALLICENCE 700 1- Satake Shinsuke Department of Thoracic Surgery, National Hyogo Central Hospital, 1314 Ohara, 669-1515, Sanda, Hyogo, Japan aut NATIONALLICENCE 773 0- Surgery Today Springer-Verlag 30/6(2000-06-01), 506-510 0941-1291 30:6<506 2000 30 595 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer