ABSTRACT
Preoperative evaluation includes a thoracic computed tomography (CT) scan with contrast agent. It provides information on the location and extent of the empyema, degree of loculation, and the integrity of the underlying lung parenchyma. Thoracoscopic decortication should be the treatment option of choice for Stage II empyema. There is sufficient evidence that thoracoscopic decortication has a superior outcome in terms of postoperative morbidity, complications, and length of hospital stay when compared with open decortication for Stage II empyema. Postresectional pleural empyema may occur after anatomical as well as wedge resections. The incidence for postlobectomy empyema is 2". For wedge resections, it is considerably lower. Postpneumonectomy empyema (PPE) is a serious complication in thoracic surgery, which carries a high mortality. As many patients with PPE present with a fulminant course and a preseptic or septic condition, stabilization of the patient is the primary goal.
