[Surgical tactics in pleural empyema with regard to the use of a carbon dioxide laser and argon plasma].

The authors analyze the experience gained in treating 30 patients with acute and 23 with chronic pleural empyema. The management policy identified the following points. Laser thoracoscopic necrectomy and empyemic cavity sanitation are indicated in acute destructive pulmonitis. A combination of temporary bronchial occlusion and laser treatment of the empyemic cavity and bronchopleural fistula should be performed after debridement of a destructive pulmonitis area from necrotic tissues. Radical treatment of chronic pleural empyema should be better conducted in the early periods by employing a plasma scalpel at all the stages of surgical intervention for hemostasis, aerostasis and sterilization of the operation field.