[Tuberculous pleural empyema: surgical aspects].

The outcomes of surgical treatment in 323 patients aged 18 to 87 years who had chronic tuberculous empyema are analyzed. The duration of the disease ranged from 4 to 54 years. The clinical picture was mild with few symptoms and a stable phase to severe with signs of pyoresorptive fever in an acute phase. A programme has been developed to treat patients with tuberculous empyema, which is based on a combination of total specific chemotherapy, local action on a tuberculous process, and final surgical intervention. The basic surgical interventions were pleurectomy and decortication of the lung in 124 (38.8%) patients; pleurectomy with decortication and resection of the lung in 31 (9.6%); pleurectomy, decortication with resection of the lung in 11 (3.4%). Forty three (13.3%) patients underwent plastic surgery with thoracoplasty and pleuropulmonectomy and 110 (34%) patients had palliative interventions as closed drainage. Postoperative complications occurred in 12.6% of patients. One patient died from progressive tuberculosis.