Surgical management with irrigation in the treatment of pleural empyema at Dong Nai General Hospital: a case series

Abstract

Introduction: Pleural empyema remains a commonly encountered condition today, carrying significant rates of morbidity and mortality. Chest drainage combined with antibiotics and respiratory physiotherapy continues to be the mainstay of treatment in early-stage empyema. With advancements in thoracic surgery, VATS combined with pleural irrigation has been proven to provide considerable clinical benefits.

Subjects and Methods: A retrospective descriptive study was conducted on 15 patients diagnosed with pleural empyema and treated surgically with placement of a pleural irrigation catheter between January 01, 2025 and October 31, 2025 at Dong Nai General Hospital.

Results: Fifteen cases were included in the study, with a mean age of 55 years; males accounted for 86.7%. The most common reasons for admission were dyspnea (46.7%) and fever (26.7%). Pneumonia was the predominant underlying cause (73.3%), right-sided lesions accounted for 80%, and 20% of patients had a RAPID score ≥ 5. VATS and pleural irrigation using a Foley catheter were performed in 53.3% and 46.7% of cases, respectively; general anesthesia was used in 53.3%. The mean operative time was 64 ± 37 minutes (25–120). The duration of in-hospital antibiotic use was 11 ± 4 days (7–21), postoperative hospital stay was 12 ± 5 days (4–21), and chest tube removal occurred after an average of 13 ± 13 days (3–45). Short- and mid-term follow-up recorded one recurrence and two deaths due to underlying comorbidities.

Conclusion: Initial outcomes of pleural empyema management at Dong Nai General Hospital are favorable. VATS contributes to reduced hospital stay, and the use of Foley catheter irrigation shows benefits in severe cases with limited surgical tolerance.