Korean J Thorac Cardiovasc Surg.  2003 Jan;36(1):21-25.

Video-assisted Thoracoscopic Decortication for Management of Postpneumonia Empyema

• Kim BY
• Oh BS
• Yang KW
• Im JS
• Seo HJ
• Park JC

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.

Keyword

Thoracoscopy; Empyema; Decorcation

MeSH Terms

Debridement
Drainage
Empyema*
Empyema, Pleural
Hospitalization
Humans
Length of Stay
Mortality
Referral and Consultation
Retrospective Studies
Thoracic Surgery, Video-Assisted
Thoracoscopy