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- W2593704710 abstract "Surgical treatment of complicated parapneumonic effusions and empyema thoracis consists of drainage and obliteration of the pleural space. Two scientific Societies have published guidelines concerning management of empyema thoracis in the near past. American College of Chest Physicians (2000) has defined criteria of high-risk for poor outcome. Parapneumonic effusions which met the criteria of high-risk for poor outcome should undergo at least chest tube drainage, that is however unsuccessful in 25-50% of cases. Intrapleural instillation of fibrinolytics, thoracoscopic drainage and thoracotomy were, according to ACCP experts, accepted modalities of management. According to British Thoracic Society guidelines (2003), surgical treatment should be offered after failure of conservative treatment with antibiotics and chest tube drainage. We have nowadays enough evidence that early thoracoscopic drainage reduces hospitalization, chest tube drainage duration and that is successful initial treatment in 90% of cases. Minimally invasive thoracoscopic drainage can effectively drain loculations, inflammatory intrapleural fluid and gel, obliterate the pleural cavity and achieve strategic position of chest drains. Thoracoscopic drainage is unsuccessful management for organizing empyemas, where decortication is the treatment of choice. Early involvement of thoracic surgeons and early thoracoscopic drainage may effectively change the prognosis and outcome of complicated parapneumonic effusions and empyema thoracis." @default.
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- W2593704710 date "2017-02-09" @default.
- W2593704710 modified "2023-09-26" @default.
- W2593704710 title "Current trends in surgical treatment of parapneumonic effusions and empyema thoracis" @default.
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