Thoracotomy in the treatment of empyema thoracis in children

ABSTRACT

1. Forty-one cases of empyema thoracis treated with intercostal thoracotomy and open drainage are reported2. In more than 80 per cent of the bacteriologically examined cases the causative organism was pneumococcus3. The comparative study of the various reports on the therapy of empyema shows that pleurotomy gives a lower death rate, a shorter recovery period, and a higher percentage of cures, than closed drainage, ribresection, and repeated aspirations4. The average recovery period of the cases was 35.8 days. With properly timed operations and subsequent establishment and maintenance of adequate drainage, the period of convalescence was reduced to less than 24.88 days, the latter being the recovery period for uncomplicated empyema cases5. The optimum time for operation is in the fifth week after the onset of pneumonia. In the presence of infections other than empyema, better results were obtained when the operation was done within the optimum time for intervention, even if there were active but regressing complications, than when the operation was postponed to a later date when the coexisting infection had completely resolved6. Well-carried out lung gymnastics contributed to the early recovery from the temporary disabilities resulting from pleurotomy.(Summary)