Video-Assisted Thoracic Surgery in the Treatment of Posttraumatic Empyema

Early VATS For Blunt Chest Trauma: A Management Technique Underutilized By Acute Care Surgeons

“…Posttraumatic empyema managed by VATS has been reported in a meta-analysis of 30 patients from six studies, to have been successful in 19 of 22 patients (86%). 9 A retrospective study by Schere et al 17 successfully managed 16 of 22 patients (72.7%) with posttraumatic empyema and concluded VATS to be a safe and effective operative strategy. Our institution had a slightly higher rate of additional interventions compared with the above literature, nevertheless, all patients were managed successfully, and there were no deaths in the empyema group from a pulmonary or infectious process.…”

Practice Management Guidelines for Management of Hemothorax and Occult Pneumothorax

“…Several surgeons have made the claim that VATS has distinct advantages over open thoracotomy for the evacuation of retained hemothorax and empyema. 28,30 Benefits named include fewer pulmonary complications, shorter time to recovery, and less long-term dis- ability. 31 Infectious complications have been shown to be higher in thoracotomy.…”

Role of thoracoscopy in acute management of chest injury

“…After empyema has formed, VATS can still be utilized to drain the infection, but conversion rates to thoracotomy are significantly higher. Scherer et al [32] found that VATS was successful in performing adequate decortication in all 14 patients in whom it was attempted. While the conversion rate was nearly double that of draining noninfected thoracic collections (18.8%), the main reason for conversion was inadequate exposure and not inadequate decortication.…”

“…Empyema occurs in 2-10% of patients after thoracic trauma [32][33][34]. The mechanism of post-traumatic empyema differs from a postinfectious empyema.…”