•  
  •  
 

Abstract

Objectives This study aimed to assess the results of video-assisted thoracoscopic surgery (VATS) in patients with chronic pleural empyema. Background Empyema thoracis (ET) is an abnormal accumulation of excess fluid in the pleural space because of infective and/or inflammatory process. Chest tube drainage or thoracocentesis is the first-line management choice for early-stage ET. Surgical intervention is the favored first-line treatment option for advanced stages of ET. Controversy still exists about the effectiveness of VATS drainage and decortication in the advanced stages of ET. Patients and methods This is a prospective study that included 30 patients with third-stage empyema. All patients were operated with open posterolateral thoracotomy in Menoufia University Hospital. Patients were followed up 1 month post-discharge from hospital. Results Conversion rate in the VATS group to open thoracotomy was 6.7%, those who converted were excluded from the study. Sixteen (57.1%) patients had positive pleural fluid culture and 10 (35.7%) patients had comorbidities. The mean operation time was 291.07 ± 56.66 min and three (10.7%) patients needed blood transfusion. Intraoperative blood loss was 209.29 ± 80.32 ml. No patients needed postoperative ICU stay or mechanical ventilation. The Wong–Baker FACES pain scale median was 4.0 (2.0–4.0). Of the patients 32.1% had postoperative complications. Conclusion VATS showed hopeful results concerning pain, operative time, blood loss, and early return to daily activities. So, VATS is recommended for the management of third- stage empyema with more accurate selection of cases and upgrading of instruments to decrease the rate of conversion to open thoracotomy.

Subject Area

Cardiac Surgery

Article Type

Original Study

Download

Share

COinS