Management of pulmonary abscesses in a surgical setting

<b>Introduction:</b> Pulmonary abscesses are uncommon complications of acute community germ pneumonia since the advent of antibiotics. However, in 11-20% of cases, medical treatment alone is insufficient. The purpose of the study is to describe the clinical, radiological and surgical features of pulmonary abscesses. <b>Methods:</b> This is a retrospective and descriptive study that took place in the thoracic and cardiovascular surgery department of the Sahloul University Hospital in Sousse from January 2000 to December 2020 on patients who were hospitalized for pulmonary abscesses. <b>Results:</b> Eighty-five cases of pulmonary abscesses were hospitalized in the ward during the study period. The average patient age was 47 years with extremes between 6 and 80 years. Twenty women and 65 men with a sex ratio equal to 3.2. The initial symptomatology was dominated by fever, dyspnea and purulent sputum. Radiologically,in 57.71% of cases, the lesion is located on the right side. Two patients received chest drainage, 10 patients were medically treated with antibiotic and physiotherapy therapy, and 72 patients were operated on. The surgery was a lobectomia in 46 cases, a bilobectomia in 1 case, a segmentectomia in 2 cases, a pneumonectomy in 4 cases, a biopsy in 3 cases, a flat in 5 cases and an atypical resection in 11 cases. The evolution was favorable in 69.84 with complications in 22 cases or 30.15. The main complications were pleural suppuration and atelectasis which were significantly more common in subjects who had a lobectomy. Four cases of death were noted, two of which were not operated on. <b>Conclusion:</b> Surgical treatment is indicated in pulmonary abscesses resistant to medical treatment as well as pulmonary necrosis extending to several lobes.