-
Review Comparative Study
[Lung abscess and necrotizing pneumonia: chest tube insertion or surgery?].
- P-B Pagès and A Bernard.
- Service de chirurgie thoracique, hôpital du Bocage Central, CHU de Dijon, 14 rue Gaffarel, Dijon cedex, France. pb.pages@live.fr
- Rev Pneumol Clin. 2012 Apr 1; 68 (2): 84-90.
AbstractLung abscesses and necrotizing pneumonia are rare complications of community-acquired pneumonia since the advent of antibiotics. Their management leans first of all on the antibiotic treatment adapted on the informed germs. However, in 11 to 20% of the cases of lung abscesses, this treatment is insufficient, and drainage, either endoscopic or percutaneous, must be envisaged. In first intention, we shall go to less invasive techniques: endoscopic or percutaneous radio-controlled. In case of failure of these techniques, a percutaneous surgical drainage by minithoracotomy will be performed. In the necrotizing pneumonia, because of the joint obstruction of the bronchus and blood vessels corresponding to a lung segment, the systemic antibiotic treatment will be poor effective. In case of failure of this one we shall propose, a percutaneous surgical drainage, especially if the necrosis limits itself to a single lobe. The surgical treatment will be reserved: in the failures of the strategy of surgical drainage, in the necroses extending in several lobes.Copyright © 2012 Elsevier Masson SAS. All rights reserved.
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