Abstract
Empyema with destroyed lung requires pleuropneumonectomy. This procedure has, however, been reported to be associated with high mortality. We herein report four patients receiving pleuropneumonectomy for tuberculous empyema between January 1992 and December 1996. All patients received antituberculosis chemotherapy before surgery. Operating time was between 469 and 648 minutes and intraoperative hemorrhage was between 1492 and 3446 ml. One patient underwent re-exploration for chylothorax on the 25th postoperative day. Vital capacity and forced expiratory volume in one second tended to decrease from 1.76±0.5 to 1.35±0.2l and from 1.31±0.4 to 1.02±0.29 l, respectively. However, there were no significant differences in arterial blood gases between preoperative values (PaO2 75.9±7.0 Torr, PaCO2 45.3±7.9 Torr) and postoperative values (PaO2 79.4±11.3 Torr, PaCO2 43.5±5.8 Torr). Neither hospital death nor recurrence of empyema has been detected so far. We conclude that pleuropneumonectomy is an effective and safe surgical procedure for properly selected patients with tuberculous empyema and destroyed lung.
