Single incision <scp>VATS</scp> decortication for 3rd stage empyema

Aljehani, Yasser; Alabkary, Sukainah

doi:10.1002/ccr3.1743

Cited by 2 publications

(1 citation statement)

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“…Patients with empyema complicated by lung abscess have a higher risk of failure with surgical intervention and a higher rate of mortality (23% compared to 14%) ( Huang et al, 2010 ). Notably, VATS was recently shown to be effective in treatment of stage III empyema in adult patients ( Hajjar et al, 2016 ; Aljehani and Alabkary, 2018 ; Reichert et al, 2018a ; Reichert et al, 2018b ; Semenkovich et al, 2018 ), where thoracotomy with decortication of visceral pleura had previously dominated. Thus, the shift from a more invasive surgical approach for stage III empyema towards VATS becomes feasible.…”

Section: Using Minimally Invasive Treatments For More Advanced-stage Empyema: a Novel Approachmentioning

confidence: 99%

From Bedside to the Bench—A Call for Novel Approaches to Prognostic Evaluation and Treatment of Empyema

et al. 2022

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Empyema, a severe complication of pneumonia, trauma, and surgery is characterized by fibrinopurulent effusions and loculations that can result in lung restriction and resistance to drainage. For decades, efforts have been focused on finding a universal treatment that could be applied to all patients with practice recommendations varying between intrapleural fibrinolytic therapy (IPFT) and surgical drainage. However, despite medical advances, the incidence of empyema has increased, suggesting a gap in our understanding of the pathophysiology of this disease and insufficient crosstalk between clinical practice and preclinical research, which slows the development of innovative, personalized therapies. The recent trend towards less invasive treatments in advanced stage empyema opens new opportunities for pharmacological interventions. Its remarkable efficacy in pediatric empyema makes IPFT the first line treatment. Unfortunately, treatment approaches used in pediatrics cannot be extrapolated to empyema in adults, where there is a high level of failure in IPFT when treating advanced stage disease. The risk of bleeding complications and lack of effective low dose IPFT for patients with contraindications to surgery (up to 30%) promote a debate regarding the choice of fibrinolysin, its dosage and schedule. These challenges, which together with a lack of point of care diagnostics to personalize treatment of empyema, contribute to high (up to 20%) mortality in empyema in adults and should be addressed preclinically using validated animal models. Modern preclinical studies are delivering innovative solutions for evaluation and treatment of empyema in clinical practice: low dose, targeted treatments, novel biomarkers to predict IPFT success or failure, novel delivery methods such as encapsulating fibrinolysin in echogenic liposomal carriers to increase the half-life of plasminogen activator. Translational research focused on understanding the pathophysiological mechanisms that control 1) the transition from acute to advanced-stage, chronic empyema, and 2) differences in outcomes of IPFT between pediatric and adult patients, will identify new molecular targets in empyema. We believe that seamless bidirectional communication between those working at the bedside and the bench would result in novel personalized approaches to improve pharmacological treatment outcomes, thus widening the window for use of IPFT in adult patients with advanced stage empyema.

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Section: Using Minimally Invasive Treatments For More Advanced-stage Empyema: a Novel Approachmentioning

confidence: 99%

From Bedside to the Bench—A Call for Novel Approaches to Prognostic Evaluation and Treatment of Empyema

et al. 2022

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The Infection Control Route in the Operating Room Effectively Reduces the Wound Infection of Patients

Tang

Ren

Miao

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Surgical care is one of the significant aspects of global healthcare, with approximately 234 million operations being conducted annually. Surgical treatment has a substantial risk of complications and death. This study was conducted to explore the application effect of the infection control route in the operating room on the wound infection prevention care of patients. The clinical data of 136 patients receiving surgical treatment from October 2018 to October 2019 were retrospectively analyzed. The participants were assigned via random draw at a ratio of 1 : 1 to receive either routine care management (control group) or the infection control route (research group). The surgical wound infections of patients in the two groups were compared. The research group had higher scores in surgical materials management and disinfectant management than the control group ( P < 0.01 ). In the research group, the total number of colonies within 5 minutes before surgery, 25 minutes after the start of surgery, and after surgery were all smaller than those in the control group ( P < 0.01 ). There were no significant differences in the grade B healing rate between the two groups ( P > 0.05 ), and the research group had a significantly higher healing rate in grade A than the control group, but its grade C healing rate and wound infection rate were significantly lower than those in the control group ( P < 0.05 ). In the research group, the length of hospital stay, the time to get out of bed, the antibiotic use duration, and the stitch removal time was significantly shorter than those in the control group ( P < 0.0001 ). The research group received a higher clinical nursing satisfaction than the control group ( P < 0.05 ). The infection control route in the operating room for infection prevention care effectively reduces the wound infection rate of patients and accelerates their postoperative recovery.

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Single incision VATS decortication for 3rd stage empyema

Cited by 2 publications

References 5 publications

From Bedside to the Bench—A Call for Novel Approaches to Prognostic Evaluation and Treatment of Empyema

From Bedside to the Bench—A Call for Novel Approaches to Prognostic Evaluation and Treatment of Empyema

The Infection Control Route in the Operating Room Effectively Reduces the Wound Infection of Patients

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