Current status and prospect of medical and surgical management for thoracic empyema

Abstract

: We sometimes encounter patients with chronic empyema of their thoracic cavity with or without air leakage. These patients often experience mental and physical problems because of restrictions in daily life and long-term treatment. Thoracic empyema is classified as acute or chronic empyema. The former is treated by antibiotics, thoracic drainage, fibrinolysis, or debridement under video-assisted thoracic surgery (VATS), while the latter is treated by managing the infection and reducing the dead space of the thoracic cavity. In this review, we summarize the procedures for various treatment methods and technical skills in the management of thoracic empyema. Chest physicians should consider the advantages and disadvantages of each method and choose an appropriate technique or possibly a combination of techniques to obtain an optimal outcome in the treatment of thoracic empyema. The techniques and knowledge described in this review will be useful for many physicians’ clinical work. Treatment methods differ among institutions, and a guideline for thoracic empyema is needed to standardize treatment of this entity in future.