[Thoracoscopic treatment of pleural empyema].

From August 1991 to May 1997 46 patients with pleural empyema in the fibrinopurulent phase underwent thoracoscopic surgery. There were 36 men and 10 women with an average age of 47 years ranging from 18 to 84. The average operating time was 77 minutes. When only one thoracostomy drain was inserted, the drainage time was 8.5 days, if two or three drainage tubes were used it was 10.5 days. The average hospital stay was 18.1 day (range from 7 to 45). We observed ten complications. Four operations had to be converted to an open procedure because of massive thickening and fibrosis of the pleura. Three patients did not tolerate one lung ventilation, once the lung did not collapse due to technical reasons and in one patient each we observed a laceration of the parenchyma and bleeding from the parenchyma. In both cases the problem was dealt with thoracoscopically. We observed a recurrent pleural empyema in four patients which occurred between the 28th and 77th postoperative day. In summary, thoracoscopic surgery in patients with pleural empyema in the fibrinopurulent phase is an effective and well tolerated alternative to open thoracotomy.