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The Authors carried out an retrospective analysis on 81 patients, 67 men and 14 women, suffering from non post-surgical thoracic empyema, to evaluate the different therapeutic procedures and respective indications. The unsuccessful response to the preserving approach (intercostal drainage and pleural lavage twice a day with specific antibiotics or antiseptics) in 56 cases, induced the Authors to carry out a video-thoracoscopy (VAT), that allowed them to define the infection stage and subsequent treatment (the carrying on of a pleural drainage-lavage in 32 cases, the transcurrent pleural irrigation in 10 cases, the open window thoracostomy followed by myoplasty in 6 cases with bronchopleural fistula, the decortication with associated pleural exeresis in 6 cases with bronchopleural fistula, the decortication with associated pleural exeresis in 6 cases, the streptokinase in pleural cavity in 2 cases). There were registered totally 3 deaths (3.7%). The Authors in conclusion assert that the VAT, carried out after the unsuccessful preserving treatment, allows the evaluation of the infection stage and consequently suggests therapy.

The aim of this study is to evaluate the utility of surgical treatment in patients with pectus excavatum (PE) or pectus carinatum (PC). Fifteen patients underwent surgical treatment because of their psycological and anatomical condition, more serious in 6 patients (5 with PE and 1 with PC). The degree of these chest wall deformities was evaluated as resulting from CT scan of the thorax, by the ratio between the transversal and the front/back diameters, according to Haller. The Authors recommend surgical operation in the post-puberal age up to 21 years because of good results obtained using Ravitch approach (only 1 case of partial relapse of PE), even though modified in PE cases with the application of flat steel prosthesis and in PC cases for uncutting the perichondral beds. The choice of surgical procedure derives, in our opinion, from the correction of these anatomic deformities and from the greater sense of improved cosmesis that might result.