Background: Pulmonary abscesses remain a life-threatening complication, particularly in patients with diabetes mellitus, where impaired immunity, altered microcirculation, and de-layed healing complicate management. Advances in diagnostics, antimicrobial therapy, and surgical techniques have improved outcomes, yet diabetic patients continue to face elevated risks.

Objective: To review and analyze current global trends, controversies, and innovations in the surgical treatment of pulmonary abscesses among diabetic populations.

Methods: A literature review was conducted using PubMed, Scopus, and Google Schol-ar databases, focusing on articles published between 2000 and 2024. Search terms included «pulmonary abscess», «diabetes mellitus», «surgical drainage», «VAC therapy», and «lung re-section». Studies were selected based on relevance to diabetic populations and emphasis on sur-gical decision-making.

Results: Diabetic patients with pulmonary abscesses exhibit more severe infections, greater cavity formation, and higher rates of sepsis and mortality. Surgical options range from minimally invasive drainage to lobectomy, with timing and modality influenced by glycemic control, cavity anatomy, and comorbidities. Novel strategies such as vacuum-assisted therapy and bronchoscopic drainage have shown promise but require further validation. A lack of stand-ardized protocols for diabetic patients contributes to variability in outcomes.

Conclusion: The management of pulmonary abscesses in diabetic patients requires a tai-lored, multidisciplinary approach. While surgical outcomes have improved with modern tech-niques, patient-specific risk factors must guide intervention. Future directions include integra-tion of VAC therapy, personalized surgical algorithms, and improved perioperative glycemic management.

Pulmonary abscess, diabetes mellitus, surgical drainage

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