We have studied clinically 42 cases of chronic empyema, admitted to our hospital during the past 5 years (1978-1982). Operative procedures applied were decortication for 17 cases, thoracoplasty for 13 cases, open treatment for 2 cases, closed tube drainage for 7 cases, and 2 cases were treated with chemotherapy alone.
In our cases, we have several cases of chronic empyema with interesting healing processes by surgical treatments.
The results of the study are summarized as follows:
1) There is a case of p.aerginosa empyema after pneumonectomy of right lung healed by the treatment with CTD+50% iodine tincture.
2) Two cases of total fistulous empyema were healed by “CTD+fistulo-obstruction thoracoplasty” alone.
3) Calcified fistulous empyema was subjected to radical operation after open treatment and removal of calcified tissue.
4) Cases excreting resistant bacteria or aspergillus were treated with opening of thorax to reduce amount of bacteria in thorax cavity.
5) Six cases under treatment are kept on O2-inhalation.
6) There are 2 cases surgically healed by air plombage against fistulous chronic empyema.
7) There were 2 cases excreting resistant bacteria with fistulous empyema after left upper lobe lobectomy healed by “roll-method pneumonectomy” which is operated against strong adhesion between V
1+2, V
3, V
4+5 and fistulous bronchus wall. The procedure is follows; at first, the left main bronchus is resected 3 cm, second, the left lower lobe lobectomy is done, and last, the remaining fistulous bronchus roll is lengthwise opened, sliced off mucous membrane and bronchial cartillages, and then the remaining bronchus wall is sutured.
8) Results of treatment were surgically healed in 80.9%, under treatment in 7.2% and died in 11.9 %.
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