Surgical treatment is often necessary for the following infectious diseases of the chest cavity.
If a bacterial infection of the punctate is detected, the pleural cavity must be drained. In the case of chambered empyema, a thoracoscopy or thoracotomy with complete evacuation of the cavity and targeted drainage is indicated.
Treatment is primarily drug-based, with a specific, long-lasting combination of antibiotics. Nowadays, surgical intervention is only indicated in complicated cases, such as persistent caverns, caverns with superinfection, pulmonary hemorrhage (hemoptysis), bronchus stenosis, tuberculoma (>2 cm) and multi-resistant pathogens. Granulomas are removed to find the cause of the accidentally discovered “tumor”.
In the case of repeated infections despite adequate antibiotic therapy and life-threatening pulmonary hemorrhage, segmental resection or lobectomy is indicated. This can be done minimally invasively and leads to a significant improvement in symptoms.
The affected part of the lung should be resected if the disease is complicated.
As a rule, treatment is conservative. Surgical intervention is rarely necessary. Indications for segmentectomy or lobectomy are failure of conservative therapy, cavern with risk of recurrence, aspergilloma, life-threatening pulmonary hemorrhage, bronchopleural fistula.
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