A 79-year-old male who had the treatment of renal failure with hemodialysis was admitted to our hospital for the management of right pleural empyema. We performed thoracoscopic débridement and pleural irrigation in the management of empyema thoracis, because both chest tube drainage and antibiotic therapy had failed. Postoperatively pleural irrigation was performed for three weeks and the chest drains were removed after four weeks. He was successfully transferred to our department of internal medicine at four weeks after the operation. Thoracoscopic débridement and pleural irrigation for the elder patient with pleural empyema is safe, effective and minimally invasive surgical procedure.

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