scholarly journals Practical management of pleural empyema

2016 ◽  
Vol 73 (3) ◽  
Author(s):  
G.F. Tassi ◽  
G.P. Marchetti ◽  
V. Pinelli ◽  
S. Chiari
Keyword(s):  
Retrospective Studies ◽  
Pleural Cavity ◽  
Pleural Empyema ◽  
Pleural Space ◽  
Space Infection ◽  
Medical Thoracoscopy ◽  
Conditioning Treatment ◽  
Pleural Infection ◽  
Considerable Morbidity

Empyema is defined as pus in the thoracic cavity due to pleural space infection and has a multifactorial underlying cause, although the majority of cases are post-bacterial pneumonia. Despite treatment with antibiotics, patients with empyema have a considerable morbidity and mortality due at least in part to inappropriate management of the effusion. Timely diagnosis of pleural space infection and rapid initiation of effective pleural drainage represent fundamental principles for managing patients with empyema. Ultrasound is particularly useful to identify early fibrin membranes and septations in the pleural cavity conditioning treatment strategy. Empyema and large or loculated effusion with a pH<7.20 need to be drained. Thoracoscopy has largely been used in pleural effusion due to lung infection. Whereas the efficacy of video-assisted thoracic surgery (VATS) in empyema management has been evaluated in several retrospective studies showing favourable results, less is known about the role of medical thoracoscopy (MT) in pleural infection. MT, appears to be safe and successful in multiloculated empyema treatment. It is also lower in cost and in frail patients is better tolerated than VATS which requires tracheal intubation.

scholarly journals ROLE OF MEDICAL THORACOSCOPY IN THE DIAGNOSIS OF PLEURAL EMPYEMA

2016 ◽  
Vol 5 (37) ◽  
pp. 2189-2192
Author(s):  
Yugandhar Bhatt C ◽  
Methuku Narender ◽  
Kiran Kumar Kondapaka ◽  
Vavilala Satish Kumar Rao ◽  
Auzumeedi Sai Kumar ◽  
...  
Keyword(s):  
Pleural Empyema ◽  
Medical Thoracoscopy

Cryotherapy in Semirigid Thoracoscopy for Debridement of Multiloculated Empyema

Respiration ◽  
2020 ◽  
Vol 99 (9) ◽  
pp. 784-788
Author(s):  
Qi Zhang ◽  
Xi Wang ◽  
Yan Hu ◽  
Fang-Fang Guo ◽  
Kun-Yao Yu ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Pleural Cavity ◽  
Surgical Intervention ◽  
Pleural Empyema ◽  
The Novel ◽  
Medical Thoracoscopy

Surgical intervention is occasionally required for the treatment of pleural empyema. Semirigid thoracoscopy is a safe and successful surgical approach utilized by interventional pulmonologists, conventionally utilizing flexible forceps and suction as the main tools, but they can sometimes be inefficient for more complicated cases. In debriding a case of multiloculated empyema with semirigid thoracoscopy, we report the novel use of cryotherapy in clearing adhesions from the pleural cavity. We found using the cryoprobe to be more efficient than using forceps and suggest further investigation into its use in medical thoracoscopy.

scholarly journals Surgical Management of Pleural Space Infection

2021 ◽  
Author(s):  
Alessandro Maraschi ◽  
Andrea Billè
Keyword(s):  
Surgical Management ◽  
Treatment Options ◽  
Pleural Space ◽  
Pleural Drainage ◽  
Healthcare Resources ◽  
Space Infection ◽  
Disease Characteristics ◽  
Number Of Patients ◽  
Trapped Lung ◽  
Considerable Morbidity

Pleural space infections are a common clinical entity affecting a large number of patients. These are associated with considerable morbidity and mortality rate and they require significant healthcare resources. In this chapter, we discuss the disease characteristics with regards to the etiology (primary and secondary), clinical presentation, radiological findings, different stages of the condition and treatment options according to stage at presentation. Conservative management (medical treatment, pleural drainage, with or without intrapleural fibrinolytic) may be effective in management of simple pleural space infections, but surgical management may be required in loculated complex empyema to prevent acute sepsis, deterioration and trapped lung. Surgical treatment of complicated pleural infections either by VATS or thoracotomy will be discussed in order to understand when to perform debridement/decortication of the pleural cavity or less frequently a thoracostomy.

Intrapleural Foreign Body: Case Report

Respiration ◽  
2021 ◽  
pp. 1-4
Author(s):  
Alessandro Di Marco Berardino ◽  
Erino Angelo Rendina ◽  
Martina Bonifazi ◽  
Lina Zuccatosta ◽  
Letizia Lara Latini ◽  
...  
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Pleural Cavity ◽  
Bronchopleural Fistula ◽  
Pleural Empyema ◽  
Pleural Space ◽  
Peripheral Airways ◽  
Pleural Surface ◽  
Body Case

The detection of foreign bodies in the pleural cavity is rare and mostly consequent to iatrogenic or traumatic events. The migration of an inhaled foreign body from the airways to the pleural space through a bronchopleural fistula is an exceptional event. We report a case of a pleural empyema consequent to an inhaled wooden skewer. CT scan and bronchoscopy were unable to identify the foreign body, due to its migration in the peripheral airways. The thin and pointed foreign body perforated the visceral pleural surface emerging in the pleural cavity.

Pleuraempyem: Kryotherapie in der Thorakoskopie nutzen

2021 ◽  
pp. 1-2
Author(s):  
Franz Stanzel
Keyword(s):  
Surgical Approach ◽  
Pleural Cavity ◽  
Surgical Intervention ◽  
Pleural Empyema ◽  
The Novel ◽  
Medical Thoracoscopy

Surgical intervention is occasionally required for the treatment of pleural empyema. Semirigid thoracoscopy is a safe and successful surgical approach utilized by interventional pulmonologists, conventionally utilizing flexible forceps and suction as the main tools, but they can sometimes be inefficient for more complicated cases. In debriding a case of multiloculated empyema with semirigid thoracoscopy, we report the novel use of cryotherapy in clearing adhesions from the pleural cavity. We found using the cryoprobe to be more efficient than using forceps and suggest further investigation into its use in medical thoracoscopy.

Management of Empyema and Bronchopleural Fistula

1987 ◽  
Vol 17 (1) ◽  
pp. 26-29 ◽  
Author(s):  
Oluwole A Adebo ◽  
Olugbenro Osinowo
Keyword(s):  
Pleural Cavity ◽  
Bronchopleural Fistula ◽  
Pleural Space ◽  
Spontaneous Closure ◽  
Outpatient Basis ◽  
Minimal Morbidity ◽  
Space Infection ◽  
Rapid Control ◽  
Complete Obliteration ◽  
Acceptable Method

Eloesser window was constructed in 8 patients with empyema and sepsis which failed to respond to more conservative measures. The empyema complicated pneumonectomy in 6 cases and was associated with bronchopleural fistula (BPF) in 4. Rapid control of the pleural space infection was obtained in all cases, allowing for further management on an outpatient basis. Closure of the fistula occurred within 4 months in 3 of 4 cases; one patient developed an oesophago-pleural fistula 31½ months later and succumbed from inanition. Spontaneous closure of the thoracostomy window with complete obliteration of pleural cavity has occurred in only 2 patients. In S others the persistent stoma with minimal drainage has been well tolerated. The Eloesser window is an acceptable method for treatment of recalcitrant empyema and BPF in our environment, with minimal morbidity and mortality.

FEATURES OF PLEURAL CAVITY DRAINAGE IN PATIENTS WITH ACUTE NONSPECIFIC PLEURAL EMPYEMA

2020 ◽  
pp. 39-42
Author(s):  
D. V. Minukhin ◽  
O. I. Tsyvenko ◽  
A. Yu. Korolevska ◽  
L. G. Tarasenko ◽  
D. Yu. Melnyk ◽  
...  
Keyword(s):  
Chest Wall ◽  
Pleural Cavity ◽  
Pleural Empyema ◽  
Pleural Drainage ◽  
Main Method ◽  
Second Stage ◽  
The Third ◽  
Third Stage ◽  
Minor Surgery ◽  
Surgical Manipulation

Most authors considered pleural cavity drainage to be the main method of treatment of acute pleural empyema using minor surgery. Despite the simplicity of drainage of the pleural cavity, the number of complications after this surgical manipulation, according to the reports of some authors, varies from 3 to 8 %. The complications of pleural drainage in the patients with acute nonspecific pleural empyema have been studied and the technique of pleural drainage "blindly" has been introduced, which allows drainage to be located along the chest wall. At the first stage of the four−stage study, the complications of pleural drainage in 38 patients with acute nonspecific pleural empyema were analyzed, at the second stage a device for drainage of the pleural cavity "blindly" was developed to place drainage in parallel to the chest wall, at the third stage patients were tested; on IV −− drainage of the pleural cavity of 34 patients was performed according to the proposed method. The reason for the development of drainage complications in the pleural cavity of patients with acute pleural empyema was the inadequate location of drainage in the pleural cavity, drainage of the pleural cavity was carried out in general hospitals without the use of thoracoscopic equipment. Curved thoracoport with trocar for a blind drainage of the pleural cavity "blindly" was developed and introduced into clinical practice. This technique eliminates the involuntary location of the drainage in the pleural cavity, installing it along the chest wall, and is safe. Complications associated with drainage of the pleural cavity according to the developed method using a curved thoracoport with a trocar, inadequate location of drainage, were not observed in patients. Key words: acute pleural empyema, pleural cavity drainage, curved trocar.

scholarly journals P-219UNIPORTAL THORACOSCOPIC DECORTICATION FOR PLEURAL EMPYEMA: ROLE OF ULTRASONOGRAPHIC PREOPERATIVE STAGING

2016 ◽  
Vol 23 (suppl 1) ◽  
pp. i59.1-i59
Author(s):  
A. Gonfiotti ◽  
Stefano Bongiolatti ◽  
S. Borgianni ◽  
R. Borrelli ◽  
A. Costagli ◽  
...  
Keyword(s):  
Preoperative Staging ◽  
Pleural Empyema

scholarly journals Pleural Empyema Menagement: A Brief Review of Litterature

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Milos Arsenijevic ◽  
Slobodan Milisavljevic ◽  
Stanko Mrvic ◽  
Dragan Stojkovic
Keyword(s):  
Surgical Procedures ◽  
General Condition ◽  
Dynamic Process ◽  
Clinical Laboratory ◽  
Pleural Empyema ◽  
Pleural Space ◽  
Parietal Pleura ◽  
Disease Development ◽  
Thoracic Empyema ◽  
Acute Empyema

AbstractPleural empyema, defined as the presence of purulent material within the pleural space, is the consequence of a suppurative process involving the serous pleural layers. Thoracic empyema is a dynamic process, inflammatory in origin and taking place within a preformed space bordered by both the visceral and parietal pleura. It is a complex clinical entity, neither a sole clinical, laboratory, nor a radiological diagnosis. The primary therapeutic aim: ‘ubi pus evacua’ — if you find pus remove it—has not changed since the age of Celsus. Therefore, treatment of the acute empyema of the pleura is directed to early and complete evacuation of empirical fluid and content, achieving full re-expansion of the lungs and eradication of the infection using appropriate surgical procedures, antibiotics and other supportive procedures. The optimum method of treating empyema should be adjusted to the condition of the patient and the stage of the disease in which the patient is located. The method of treatment depends on the etiology (pneumonic or traumatic), the general condition of the patient and the stage of disease development. By reviewing the available literature, it can be concluded that treating the pleural empyemas is a demanding procedure, in which it is necessary for the treating physician to apply all of his knowledge, and that there is good cooperation with the patient.

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