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  • Title: Early thoracoscopic debridement and drainage as definite treatment for pleural empyema.
    Author: Sendt W, Förster E, Hau T.
    Journal: Eur J Surg; 1995 Feb; 161(2):73-6. PubMed ID: 7772634.
    Abstract:
    OBJECTIVE: To report our experience with early thoracoscopic debridement and drainage in the treatment of pleural empyema in the fibrinopurulent or early organising phase. DESIGN: Prospective open study. SETTING: District hospital, Germany. SUBJECTS: 10 Patients operated on between August 1991 and April 1993. INTERVENTIONS: Double lumen intubation, followed by thoracoscopic opening of the empyema, evacuation of all pus under vision, debridement of the lung, irrigation of the thoracic cavity and insertion of a chest drain. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: Cultures taken during the operation grew no pathogens in five cases; Streptococcus pneumoniae, and haemolytic streptococci (once in combination with Staphylococcus aureus), were cultured in two cases each; and Mycobacterium tuberculosis in one. Chest drains were removed a mean of 8.5 days after operation. All patients were well without signs of infection 1-21 months later, and in no case was conversion to open operation necessary. CONCLUSION: Early thoracoscopic debridement and drainage is a safe and effective alternative to open treatment of patients with pleural empyema in the fibrinopurulent or early organising phase.
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