Surgical results in secondary nonspecific pleural empyema

During a 12-year period (1975-1987) 448 patients with secondary nonspecific pleural empyema have been treated--84.8 per cent males and 15.2 per cent females. In 78.1 per cent of the patients the empyema was complication of pneumonia and acute suppurative-destructive diseases of the lungs, in 9.6 per cent--of blunt chest trauma and in 6.3 per cent occurred after abdominal operations. Subtotal and total empyema had 46.7 per cent of the patients with acute empyema and 35.6 per cent of those with chronic empyema. It is pointed out that largely for subjective reasons the diagnosis and early adequate treatment of empyema was delayed which led to subsequent chronification. In 257 patients with acute empyema covered aspiration drainage was applied (89.9 per cent of the patients): 81.4 per cent were cured, 13.8 per cent experienced improvement and 4.8 per cent died. The most common surgical intervention in the 191 patients with chronic empyema was pleurectomy with decortication of the lung (57.6 per cent of the cases); 97.3 per cent of the operated patients were cured, 1.8 per cent improved and 0.9 per cent died.