Video-assisted Thoracoscopic Decortication for Management of Postpneumonia Empyema.
- Author:
Bo Young KIM
1
;
Bong Suk OH
;
Ki Wan YANG
;
Jin Soo IM
;
Hong Joo SEO
;
Jong Cheol PARK
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Sangmoo Hospital, Gwang-Ju, Korea. bykim@mail.ktcs.or.kr
- Publication Type:Case Report
- Keywords:
Thoracoscopy;
Empyema;
Decorcation
- MeSH:
Debridement;
Drainage;
Empyema*;
Empyema, Pleural;
Hospitalization;
Humans;
Length of Stay;
Mortality;
Referral and Consultation;
Retrospective Studies;
Thoracic Surgery, Video-Assisted;
Thoracoscopy
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2003;36(1):21-25
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) for decortication or debridement in the management of empyema thoracis has increased the available treatment options but requires validation. We present and evaluate our technique and experience with thoracoscopic management of pleural empyema, irrespective of chronicity. MATERIAL AND METHOD: VATS debridement or decortication was performed with endoscopic shaver system in 40 consecutive patients presented with pleural space infections. A retrospective review was performed and the effect of this technique on perioperative outcome was assessed. RESULT: VATS evacuation of infected pleural fluid and decortication was successfully performed in 35 of 40 patients. The mean duration of preoperative symptoms before referral was 23 +/- 1.8 days. The mean duration of hospitalization before transfer was 13.5 +/- 1.5 days. Blood loss was 250 to 200 mL. Intercostal drainage was required for 5 +/- 3 days. The postoperative hospital stay was 5 +/- 0.7 days. There were no operative mortalities. CONCLUSION: Video-assisted evacuation of infected pleural fluid and decortication is an effective modality in the management of the fibropurulent stage of empyema. An organized empyema should be approached thoracoscopically, but may require open decortication.
