Surgical Management for Necrotizing Pneumonia and Lung Abscess.

Lung resection for necrotizing pneumonia and lung abscess is often required to treat septic complications from refractory lung infections. All extents of parenchymal resection can be performed either by thoracotomy or thoracoscopic to successfully remove destroyed non-functional parenchyma while preserving viable tissue. Lobectomy is the commonest anatomic procedure while creation of pedicled muscular and pericardial flaps for stump reinforcement or space obliteration is common adjunct. As single lung ventilation is required for anatomic resections, treatment of any contralateral respiratory infection is mandatory. Respiratory support is not a contraindication but ventilated patients and those in ECMO are at higher risk. Early intervention and hemodynamic stabilization are important for improved outcomes.