PURPOSE: Surgical treatment of pleural and pulmonary infections may be often very difficult, despite advances in diagnostic methods, surgical techniques and supportive therapy. Patient presents dispnea, parapneumonic effusion, and sometimes pulmonary lesions. The aim of our study was to analyze the results of surgical treatment and identify clinical predictor of poor outcome.
METHODS: From 2002 to 2006 a total of 48 patients underwent decortication for pleural and pulmonary infections. All 48 patients had definitive resolution of the problem. There was no mortality. In 15 cases we perfomed VATS and in 33 cases we executed an open surgical approach. After the surgical treatment, all the patients were submitted to washing the pleural space with antithrombotic drugs.
RESULTS: Altogether, 33 patients underwent thoracotomy and the main treatment was decortication with surgical pulmonary resection in 28 cases; 15 patients underwent videothoracoscopy and the treatment of decortication was performed with surgical pulmonary resection in 9 cases. Histologic examinations showed the presence of pneumonia, in the majority of cases associated to granulomatouse disease.
CONCLUSION: Definitive results of the surgical procedures assessed at the 6-month follow-up examination were good in all the patients. Decortication with resection of pulmonary infection, when necessary, is a higly effective treatment for pleural and lung infections and may be performed with mini-invasive approach with low morbidity and mortality. Because of prolonged duration of symptoms and conservative treatment increase morbidity, early surgical intervention seems to be the optimal modality for the treatment of pleural and pulmonary infections.
CLINICAL IMPLICATIONS: The prevalence of risk for pneumonia in the population is significant. Decortication with resection of pulmonary infection is today a higly effective treatment for pleural and lung infections.
DISCLOSURE: Pierpaolo Bregamassone, No Financial Disclosure Information; No Product/Research Disclosure Information