Abstract:
INTRODUCTION:Parapneumonic pleural effusions arise from pneumonia and may develop into pleural empyema (PE). PE is defined as collection of pus in the pleural space with secondary inflammation of the visceral and parietal pleura. This review article describes the current treatment strategies for para- and postpneumonic PE both in children and adults. MATERIAL AND METHODS:Selective literature research via Medline (key words: pleural empyema, pleural empyema in children, thoracic empyema) and presentation of our own clinical experience with therapy recommendations. RESULTS:The incidence of postpneumonic PE is increasing in both children and adults. PE is associated with a high morbidity and mortality if it is not treated early and adequate. Progression of PE follows a characteristic morphological course, which is classified in three stages: the exsudative, fibrinopurulent, and organizing phase. Treatment should be adapted to these three phases including systemic antibiotic therapy and drainage of the pleural space. Intrapleural fibrinolysis can be performed with good success independent of age in the transition of stage 1 and 2. In persistent PE (stage 2), thoracoscopic decortication is recommended to avoid progression into the organizing phase (stage 3) with the need of an open decortication. In debilitated elderly patients the increasing use of intrathoracic vacuum therapy (Mini-VAC/Mini-VAC-instill) offers an effective and less invasive therapy option. CONCLUSION:Para- and postpneumonic PE requires an individualized and stage adapted therapy using a combination of medical and surgical treatment strategies with the aims of removing the source of infection and ensuring re-establishment of lung expansion.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Ried M,Graml J,Großer C,Hofmann HS,Sziklavari Zdoi
10.1055/s-0035-1557771subject
Has Abstractpub_date
2015-10-01 00:00:00pages
S22-8eissn
0044-409Xissn
1438-9592journal_volume
140 Suppl 1pub_type
杂志文章,评审abstract::Isolated hypoxic perfusion (IHP) is a commonly used technique in the treatment of abdominal malignancies. During a phase II-study the pathophysiology of this technique was explored in patients with advanced pancreatic cancer. Twenty perfusions of the abdomen were performed in 17 patients. Under general anesthesia, fem...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract:UNLABELLED:In 35 patients with diabetic gangrene, amputation above the ankle (n = 18) or below the ankle (n = 17) was planned by nonspecialised general surgical departments or practicing surgeons. Prior to the operation, these patients presented to a specialised diabetic foot clinic; their clinical courses were analyse...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::741 cholecystektomies were examined for cholesterosis. In 92% gallstones were present and in 8% there were no stones. Cholesterosis of the gallbladder was found in 0,9% of 4417 autopsies. It was combined with gallstones in 25% and in 75% it was not. There was no difference concerning the clinical symptoms between chol...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract::Between 1971 and 1988 74 operations for intestinal complications following radiotherapy were performed on 67 patients at the Second Surgical Department, University of Vienna. The lesions were located in the small bowel (n = 41) and in the sigmoid colon/rectum (n = 33). 98.5% of the patients were females, the most freq...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract::During the past 10 years, postoperative mortality associated with resection of oesophageal carcinoma has been reduced from 30% to 11%. However, all efforts to improve longterm survival with extensive excisional procedures and adjuvant chemotherapy and radiotherapy have failed. Fifty-three of 100 patients presenting to...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1992-01-01 00:00:00
abstract::The surgical management of defects in the pelvic region is a great surgical challenge. Primary tumor recurrences have to be addressed and local infections require appropriate therapy such as rigorous debridement and antibiotic therapy. Plastic surgery provides tissue reconstruction by well perfused flaps and also rees...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2006-955456
更新日期:2006-12-01 00:00:00
abstract::Reported in this paper is experience obtained since 1978 from surgical removal of the tracheal bifurcation in combination with pneumonectomy in 38 cases. Squamous cell carcinoma centrally growing from the upper lobe was recorded from 24 patients to whom 36 interventions had been applied for bronchial carcinoma. 50 per...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::At present the technique of selective proximal vagotomy (SVP) seems to be standardized. Nevertheless, the surgical procedure is practiced by many authors in a different way concerning the proximal and distal borderline of denervation. In our opinion pylorplasty should only be performed in those patients suffering from...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:In spite of dynamic development of modern diagnostic and therapeutic methods, the long-term results of surgical therapy in pancreatic cancer are still unsatisfying. The aim of this study was to analyse long-term results of surgical palliation for pancreatic cancer in a pancreatic surgery centre. METHODS:We ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2002-35760
更新日期:2002-11-01 00:00:00
abstract::Mean nerve root diameters of thoracal, lumbal and sacral roots have been determined and the corresponding cross section areas calculated. The myelinated axons of these roots have been counted and the axon densities calculated. The myelinated axons of 3 lower intercostal nerves have also been counted. One intercostal n...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::Currently, there is no structured training plan to become a transplant surgeon in Germany. Similar to the Anglo-Saxonian educational system we have implemented a 3-year fellowship in transplant and hepatic-, pancreatic-, biliary (HPB) surgery. The educational curriculum is based on the guidelines of the European Board...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0032-1328738
更新日期:2014-06-01 00:00:00
abstract::Retrograde intramedullary fixation of proximal humerus fractures with flexible wires was evaluated in a prospectively documented study. Seventy-four fractures in 73 patients with unstable proximal humerus shaft or neck fractures were fixed with 3-11 flexible intramedullary wires. The age of the patients averaged 72 ye...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract:INTRODUCTION:We report on our results of MIVAT operations. METHOD:Nineteen Patients including 15 females and 4 males were operated with MIVAT, corresponding to 11 % of all patients undergoing an operation for benign goitre in our hospital. A single node of the thyroid gland within 30 mm and enlargement of a thyroid lo...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2003-41392
更新日期:2003-08-01 00:00:00
abstract::Various forms of compartment syndrome can now be distinguished. Acute compartment syndrome is the result of a discrepancy between the volume of the compartment and its contents. This leads to increased pressure at rest and during load, which cuts off the micro-circulation and hence destroys the intracompartmental stru...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2001-14770
更新日期:2001-06-01 00:00:00
abstract::The necessity of limiting health care costs requires adequate service recording and quality control even in visceral surgery. In this field, the safety of the anastomoses is of greatest importance. Anastomoses at risk are esophageal connections to jejunum or colon and deep rectal anastomoses. At these locations expens...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::The granulocyte phagocytosis test, Karnofsky index, and ASA standard were used in the context of 287 patients for general surgery, for the purpose of retrospective elucidation of the relationship between presurgical prognostication and postsurgical complications. Sensitivity, specificity, and "predictive values" were ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::Occurrence of postoperative wound dehiscence with fistulae in stomach and small intestine is considered to be a severe surgical complication. The question has been raised, if the problem should be therapeutically tackled by means of surgery or medication in the context of intensive care. Retrospective and prospective ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::Dr. Rahel Hirsch was only the second woman to attain a professional medical position at the Charité Hospital in Berlin. For more than 16 years, she worked in Clinic II Internal Medicine. In 1906, she discovered that solid particles are able to pass from the veins and arteries into urine (Hirsch-Effect). The results of...
journal_title:Zentralblatt fur Chirurgie
pub_type: 传,历史文章,杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Continuous arteriovenous hemofiltration is the treatment of choice for postoperative acute renal failure (ARF). The clinical value of two different treatment modalities (spontaneous vs. pump-driven hemofiltration PDHF) were compared in two groups of patients with postoperative ARF. There were no differences in both gr...
journal_title:Zentralblatt fur Chirurgie
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1991-01-01 00:00:00
abstract::We recommend explorative laparotomy with splenectomy in the field of Hodgkin's lymphoma even in childhood. Operation is an early therapeutic and diagnostic method enabling further treatment to be made in relation to the stages of the disease. A chance of better survival seems to exist in children with Hodgkin's diseas...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::Background An enterothorax with herniation of bowel segments through a diaphragmatic defect is a rare postoperative complication, which can occur in the early postoperative period as well as several months or even years after the primary procedure. In virtually all cases, this diagnosis requires surgical treatment wit...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-119304
更新日期:2017-02-01 00:00:00
abstract::We report on the early and late complications after hernia repair in this retrospective study. Over a period of five years, 920 adult men underwent Bassini-Kirschner repair for inguinal hernia as first operation. There occurred six hematomas (0.6%), 11 seromas (1.2%) and 10 wound infections (1.0%). There were no death...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Background: Since 2006 the practical year in the Mannheim Reformed Curriculum Medicine (MaReCuM) is divided into four quarters: the two required subjects (surgery and internal medicine), one elective and one of four offered fields in ambulatory medicine. Therefore students can more intensively focus on their preferenc...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0035-1546248
更新日期:2017-02-01 00:00:00
abstract::From 1982 through April 1992, 192 patients underwent extended resection for non-small cell carcinoma of the lung (NSCLC) invading the chest wall (n = 52) or the mediastinum (n = 140). Complete resection of the tumor was possible in 81 (58%) patients with invasion of mediastinum and in 34 (65%) patients with invasion o...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Treatment was applied to 181 patients for acute pancreatitis at the Surgical Department of Friedrichshain Local Hospital, between December 1, 1985 and October 30, 1987. Ninety-two of these patients were in Stage I according to Kümmerle-Hollender, 62 in Stage II, and 27 in Stage III. Operations were performed on 57 pat...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::Background: The fact that medical treatment is associated with errors has long been recognized. Based on the principle of "first do no harm", numerous efforts have since been made to prevent such errors or limit their impact. However, recent statistics show that these measures do not sufficiently prevent grave mistake...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0041-107444
更新日期:2017-02-01 00:00:00
abstract::Minor amputations are frequently performed in neuroischemic or neuropathic lesions of the diabetic foot. In German-speaking countries, the term "Grenzzonenamputation" was created to describe the combination of minor amputation exactly in the border zone to vital tissues, necrosectomy and débridement. For early and opt...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-2003-42748
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:The increasing number of endovascular procedures made aware of a kidney disease induced by contrast media (CM). Contrast-induced nephropathy (= CIN) can develop in 0.6-44 % of the treated patients by angiography and / or endovascular intervention. The incidence in high-risk patients ranges from 50 to 70 %. I...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0031-1283759
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:The prevalence of morbid obesity and its sequelae is increasing in Germany, Europe and worldwide. Bariatric surgery is thus gaining in importance for the treatment of patients with malignant obesity. Creation of a gastric bypass is one of the most frequently performed procedures for obesity. DISCUSSION:The ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1098812
更新日期:2009-02-01 00:00:00
abstract::The prognosis of patients with rectal cancer has been improved significantly after introduction of the total mesorectal excision (TME). Just by performing TME, the local recurrence rates could be decreased to less than 10 %, independent of multi-modal therapeutic concepts. In contrast, the local recurrence rate reache...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-2006-921552
更新日期:2006-04-01 00:00:00