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JOURNAL ARTICLE
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[Evolution of complex treatment of patients with non-specific pleural empyema].

AIM: To analyze long-term own experience of NPE treatment in view of evolution of surgical sanitation of pleural cavity.

MATERIAL AND METHODS: The analysis included 5115 patients with NPE for the last 39 years (1977-2015). Morbidity, features of microflora of purulent exudate, changes in the structure of surgical methods were assessed. The role of computed tomography in the diagnostic algorithm and treatment of NPE was studied.

RESULTS: The evolution of NPE surgical management includes introduction of video technologies, thermal surgical instruments and widespread use of computed tomography in the diagnosis of pleural empyema. So, significant reduction of patients who were discharged with residual cavities was observed. Postoperative mortality was 19.5% for the period 1977-1996 when traumatic open surgery was used. At the same time there were no deaths within 1997-2015 due to introduction of VATS pleural drainage. Overall mortality decreased from 4.9% to 3.2% for the same period due to reduced postoperative complications.

CONCLUSION: The introduction of minimally invasive technologies, new thermal surgical instruments changed management of NPE patients, reduced the number of traumatic open procedures. So, improved outcomes were achieved.

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