ArticleCureus2025
Superiority of Surgical Treatment in Stage 2 Acute Empyema: A Perspective on Lung Volume Improvement.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Empyema space rate: a quantitative predictor of postoperative drainage duration after surgery for acute empyema.General thoracic and cardiovascular surgery · 2026Article
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionEarly surgery for acute empyema can shorten hospitalization and reduce complications, especially in Stage 2 cases. Inflammation and fibrosis can impair long-term pulmonary function, but few studies have evaluated post-treatment lung recovery. We hypothesized that surgery promotes better lung re-expansion than drainage alone. To test this hypothesis, we analyzed lung volume changes on computed tomography (CT) scans before and after treatment.
methodsThis retrospective, single-center study included adult patients with Stage 2 acute empyema treated from 2012 to 2024 at Kofu Municipal Hospital, Kofu, Japan. Patients were included if they had CT scans before treatment and at least one month after discharge. CT-based lung volumes were analyzed using SYNAPSE VINCENT
resultsAmong 131 Stage 2 empyema cases, 25 met the inclusion criteria (10 surgery and 15 drainage). Surgery was performed after a median of seven days due to poor drainage. The surgery group showed significantly better lung improvement (82% vs. 68%, p < 0.01). Hospital stay and drainage duration were similar, but antibiotic use tended to be longer in the drainage group. After matching (nine patients per group), lung improvement remained superior in the surgery group (79% vs. 66%, p = 0.012). A statistically significant time-dependent improvement in total lung volume was observed in the surgery group following treatment (p = 0.04). DISCUSSION: Surgical intervention led to better lung volume recovery than drainage alone. However, selection bias may exist, as surgery was often delayed until after drainage failure. In three cases, limited decortication may have reduced recovery. This study only included patients with follow-up CT scans and good outcomes, potentially underestimating the full impact of treatment. Early surgical intervention may provide greater benefits by preventing disease progression and facilitating lung re-expansion.
conclusionSurgery for Stage 2 acute empyema significantly improves post-treatment lung volume recovery. Early surgical intervention should be considered in appropriate cases to optimize pulmonary outcomes.
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