Thorac cardiovasc Surg 2017; 65(07): 586-588
DOI: 10.1055/s-0036-1597592
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Georg Thieme Verlag KG Stuttgart · New York

A Simplified Technique for Drainage of Chronic Calcified Pleural Empyema

Sani Rabiou
1  Department of Thoracic Surgery, CHU Hassan II, Fes, Morocco
,
Hama Younssa
2  Department of General Surgery, HNN, Niamey, Niger
,
James Didier
2  Department of General Surgery, HNN, Niamey, Niger
,
Magagi Ibrahim
3  Department of General Surgery, HNZ, Zinder, Niger
,
Adamou Harissou
3  Department of General Surgery, HNZ, Zinder, Niger
,
Ousseini Adakal
4  Department of General Surgery, HRM, Maradi, Niger
,
Rachid Sani
2  Department of General Surgery, HNN, Niamey, Niger
› Author Affiliations
Further Information

Publication History

23 September 2016

06 November 2016

Publication Date:
28 January 2017 (eFirst)

Abstract

Chronic pleural pocket has well-known diagnosis and treatment principles since first described by Hippocrates 2,400 years ago. However, its treatment remains constant even though its causes, severity during management, and terrain vary considerably. In well-structured health care systems, posttuberculous empyema has become rare; its well-codified medical treatment relies on early diagnosis and adapted antibiotherapy, punctures/drainage, and appropriate intrapleural antifibrinolytics. In developing countries, a poor health organizational system increases the incidence of pleural pocket, which can progress until surgery is indicated. In such a context, the general principles of treatment include pleural decortication along with pulmonary resection. This technique remains difficult, risky, and, sometimes, impossible due to the chronicity of the lesion. In patients debilitated by several months of septic evolution, a simplified thoracostomy technique permits complete resection of the pocket.