[Treatment of thoracic empyema in recent 6 years; analysis of 944 cases in Japan].

944 cases of thoracic empyema were treated surgically in a 6-year period (from 1981 through 1986) in 37 institutions under supervision of Ryoken. Preoperative backgrounds, operative modes and surgical results are evaluated. Preoperative backgrounds are as follows; Acute cases comprised only 5.5% of the total. Primary cases outnumbered postoperative ones, the former occupying 65.8% of the total. Fistulous empyema comprised 68.6% of the total. Extension of the empyema; total empyema 56.0%, partial empyema 44.0%. Concerning respiratory reserve, those with FEV1/VCpr (to be denominated RI) less than 40 comprised 44.3% of the total. As to bacteriological findings; positive 49.9%, negative 40.0%, unknown 10.1%. Surgical modes; Pleuroresection 20.8%, decortication 22.4%, space-reducing 28.6%, air-plombage 9.7%, open drainage 6.8%, closed drainage 4.3%, others 7.4%. Overall results; success 83.8%, unsuccess 11.5%, death 4.7%. Those with positive microorganisms and RI less than 40 fared most poorly; success 73.2%, unsuccess 19.7% death 7.1%. Those with negative microorganisms and RI more than 41 fared most well; success 97.9%, unsuccess 1.5%, death 0.5%. Success rate with regard to surgical modes; air-plombage 95.7%, decortication 95.3% pleuroresection 92.6%, space-reducing 80.0%, closed drainage 68.3%, open drainage 29.7%.