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Ann Thorac Surg 1987;44:356-359
© 1987 The Society of Thoracic Surgeons

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Articles

Tube Drainage of Lung Abscesses

From the Cleveland Clinic Foundation, Cleveland, OH and the Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

Accepted for publication February 26, 1987.

^* Address reprint requests to Dr. Todd, Toronto General Hospital, 10EN-228, 200 Elizabeth St, Toronto, Ontario, Canada M5G 2C4

We treated 14 patients who had complicated lung abscesses (all over 4 cm in diameter); 9 patients had concomitant respiratory failure requiring mechanical ventilation. A percutaneous tube was inserted in 11 patients (3 subsequently underwent rib resection) and 3 underwent rib resection with operative insertion of the tube. The resultant bronchopleural fistulas did not interfere with respiratory management despite the use of mechanical ventilation, and only 2 patients required subsequent surgical closure. Eleven patients were discharged from the hospital. Complications were minimal and consisted of 2 episodes of hemorrhage, 1 during operative debridement of the abscess and 1 delayed. Both complications were managed successfully. Three patients died in the hospital, only 1 from complications of the lung abscess. We have concluded from this review that tube drainage can be safe, simple, and efficacious. We recommend it for the treatment of complicated lung abscesses even when associated with respiratory failure and mechanical ventilatory support.

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