Optimization of the diagnosis and treatment of purulent diseases of the pleura

Authors

  • V. G. Getman Shupyk National Healthcare University of Ukraine, Kyiv
  • A. G. Vysotskyy Shupyk National Healthcare University of Ukraine, Kyiv
  • S. S. Pitukh Kyiv City Clinical Hospital No. 17
  • O. V. Seikovskyi Kyiv City Clinical Hospital No. 17
  • Yu. Ph. Koshak I. Horbachevsky Ternopil National Medical University

DOI:

https://doi.org/10.11603/2414-4533.2023.1.13811

Keywords:

empyema of the pleura, video thoracoscopic operations, drainage of the pulmonary cavity

Abstract

The aim of the work: improving the results of treatment of patients with empyema of the pleura by improving diagnostics and surgical care.

Materials and Methods. 1320 inpatients from 2002 to 2017 who were treated in the Department of Thoracic Surgery of the Communal Non-profit Enterprise "Kyiv City Clinical Hospital No. 17" with a diagnosis of pleural empyema were retrospectively studied. The me­thods used in the research are clinical, statistical, laboratory.

Results and Discussion. Methods of minimally invasive surgery were used in the treatment of 1282 (97 %) patients, of which: drainage of the pleural cavity was performed in 846 patients (66 %), polydrainage of the pleural cavity was performed in 344 patients (26.8 %), VATS – in 75 patients (5.9 %), puncture treatment was applied to 17 patients (1.3 %). The experience of providing assistance to patients with purulent diseases made it possible to define and work out the diagnostic algorithm of treatment, as well as to reduce the average time of drainage of the pleural cavity. VATS makes it possible to achieve good results in the treatment of EP, as well as to reduce the percentage of chronicity of the process, especially if an individual approach is followed in the treatment of each patient.

According to the results of treatment, complete recovery was achieved in 1051 (80 %) patients, 145 (11 %) patients were discharged with improvement, 80 (6 %) patients with chronic course were discharged for outpatient treatment. Fatal outcome – 44 patients (3 % of all treated cases).

References

Tronina, O.Yu. (2017). Suchasni pidkhody do likuvannia hostroi empiiemy plevry (ohliad literatury) [Modern approaches to the treatment of acute empyema of the pleura (literature review)]. Shpytalna khirurhiia – Hospital Surgery. Journal named after L. Ya. Kovalchuk, 4, 102-108 [in Ukrainian].

Feshchenko, Yu.I., Golubovska, O.A., Honcharov, K.A., Dziublyk, O.Ya., Dziublyk, Ya.O., Dmytrychenko, V.V., Kapitan, G.B. et al. (2013). Nehospitalna pnevmoniia u doroslykh osib: etiolohiia, patohenez, klasyfikatsiia, diahnostyka, antybakterialna terapiia (proekt klinichnykh nastanov). [Community-acquired pneumonia in adults: etiology, pathogenesis, classification, diagnosis, antibacterial therapy (draft clinical guidelines)]. Ukr. pulmonol. zhurn. – Ukrainian Pulmonology Journal, 1, 5-21 [in Ukrainian].

Scarci, M., Abah, U., Solli, P., Page, A., Waller, D., Van Schil, P., ... & Cardillo, G. (2015). EACTS expert consensus statement for surgical management of pleural empyema. European Journal of Cardio-Thoracic Surgery, 48 (5), 642-653. DOI: https://doi.org/10.1093/ejcts/ezv272

Opanasenko, M.S., Shalagai, S.M., Kshanovskyi, O.E., Levanda, L.I. (2017). Efektyvnist pariyetalnoi plevrektomii z dekortykatsiieiu leheni ta rezektsiieiu vrazhenykh patolohichnym protsesom dilianok lehenevoii tkanyny u khvorykh ftyzio-pulmonolohichnoho profiliu [Effectiveness of parietal pleurectomy with decortication of the lung and resection of areas of lung tissue affected by the pathological process in patients with a phthisio-pulmonological profile]. Ukr. pulmonol. zhurn. – Ukrainian Pulmonology Journal, 1, 20-24 [in Ukrainian].

Grubnik, V.V., Tronina, O.Yu., Shipulin, P.P., Baidan, V.I. & Baidan, V.V. (2019). Likuvannia hostroii empiiemy plevry. Vlasnyi dosvid vykorystannia suchasnykh maloinvazyvnykh khirurhichnykh tekhnolohii [Treatment of acute pleural empyema. Own experience of using modern minimally invasive surgical technologies]. Kyiv [in Ukrainian].

Walker, C.A., Shirk, M.B., Tschampel, M.M., & Visconti, J.A. (2003). Intrapleural alteplase in a patient with complicated pleural effusion. Ann. Pharmacother., 37 (3), 376-379. DOI: https://doi.org/10.1345/aph.1C248

Shipulin, P.P., Baydan, V.V., Martynyuk, V.A., Baydan, V.I., Kyrylyuk, A.A., Kozyar, O.N., Severgin, V.E., Polyak, S.D. (2009). Mozhlyvosti videotorakoskopichnoi rezektsii leheni v torakalnii khirurhii [Possibilities of videothoracoscopic lung resection in thoracic surgery]. Klinichna khirurhiia – Clinical Surgery, 9, 43-46 [in Ukrainian].

Porcel, J.M., & Light, R.W. (2009). Parapneumonic pleural effusions and empyema in adults: current practice. Revista Clinica Espanola, 209 (10), 485-494. DOI: https://doi.org/10.1016/S0014-2565(09)72634-7

Luh, S.P., Chou, M.C., Wang, L.S., Chen, J.Y., & Tsai, T.P. (2005). Video-assisted thoracoscopic surgery in the treatment of complicated parapneumonic effusions or empyemas. Chest, 127 (4), 1427-1432. DOI: https://doi.org/10.1016/S0012-3692(15)34497-4

Haghshenasskashani, A., Rahnavardi, M., Yan, T.D., & McCaughan, B.C. (2011). Intrathoracic application of a vacuum-assisted closure device in managing pleural space infection after lung resection: is it an option? Interactive Cardiovascular and Thoracic Surgery, 13 (2), 168-174. DOI: https://doi.org/10.1510/icvts.2011.267286

Downloads

Published

2023-03-30

How to Cite

Getman, V. G., Vysotskyy, A. G., Pitukh, S. S., Seikovskyi, O. V., & Koshak, Y. P. (2023). Optimization of the diagnosis and treatment of purulent diseases of the pleura. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (1), 45–49. https://doi.org/10.11603/2414-4533.2023.1.13811

Issue

No. 1 (2023)

Section

EXPERIENCE OF WORK

License

Copyright (c) 2023 .

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  
  2. Лицензия Creative Commons
  3. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  4. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)