Video-Assisted Thoracoscopic Surgery of Parapneumonic Empyema – a 10-year Single-Centre Experience

H, Höfken; Herrmann, Dominik; Ewig, Santiago; Volmerig, Jan; Hecker, Erich

doi:10.1055/a-0648-0145

Cited by 10 publications

(6 citation statements)

References 19 publications

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“…The option of early thoracic-surgical intervention should be decided on by an interdisciplinary treatment team (35) (for hepatic hydrothorax, see eBox 2). A new study of VATS in the management of parapneumonic pleural empyema underscores the high success rate of early intervention but nonetheless reveals a high mortality (inhospital mortality of 8.1%), particularly when the appropriate diagnosis and treatment are delayed (36).…”

Section: The Special Features Of Pleural Infectionsmentioning

confidence: 99%

Pleural Effusion in Adults—Etiology, Diagnosis, and Treatment

Jany¹,

Welte²

2019

Deutsches Ärzteblatt International

157

129

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Background: Pleural effusion is common in routine medical practice and can be due to many different underlying diseases. Precise differential diagnostic categorization is essential, as the treatment and prognosis of pleural effusion largely depend on its cause. Methods: This review is based on pertinent publications retrieved by a selective search in PubMed and on the authors' personal experience. Results: The most common causes of pleural effusion are congestive heart failure, cancer, pneumonia, and pulmonary embolism. Pleural fluid puncture (pleural tap) enables the differentiation of a transudate from an exudate, which remains, at present, the foundation of the further diagnostic work-up. When a pleural effusion arises in the setting of pneumonia, the potential development of an empyema must not be overlooked. Lung cancer is the most common cause of malignant pleural effusion, followed by breast cancer. Alongside the treatment of the underlying disease, the specific treatment of pleural effusion ranges from pleurodesis, to thoracoscopy and video-assisted thoracoscopy (with early consultation of a thoracic surgeon), to the placement of a permanently indwelling pleural catheter. Conclusion: The proper treatment of pleural effusion can be determined only after meticulous differential diagnosis. The range of therapeutic options has recently become much wider. More data can be expected in the near future concerning diagnostic testing for the etiology of the effusion, better pleurodetic agents, the development of interventional techniques, and the genetic background of the affected patients.

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Section: The Special Features Of Pleural Infectionsmentioning

confidence: 99%

Pleural Effusion in Adults—Etiology, Diagnosis, and Treatment

Jany¹,

Welte²

2019

Deutsches Ärzteblatt International

157

129

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“…While the anaerobic bacterial infection will show subacute clinical symptoms (Touray et al, 2018). Clinical symptoms will begin to be felt after >7 days since the first time you get symptoms such as unproductive cough, subfebrile fever, bad breath, leukocytosis and anemia (Höfken et al, 2018) In this case the patient complained of shortness of breath, severe shortness of breath for 1 week Before coming to the hospital, the patient had been feeling short of breath since 2 months ago (Moffett et al, 2011). Previously, the patient had complaints of cough, greenish-yellow phlegm since 2 months ago, right chest pain, fever, night sweats, decreased appetite, weight loss of 10 kg in the last 2 months (Davies et al, 2010).…”

Section: Case Discussionmentioning

confidence: 99%

Shortterm Outcome Air Plombage Thoracoplasty of Empyema Thoracis at Pulmonary Tuberculosis

Chan¹,

Bergant²,

Aulia³

2022

KESANS

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Pulmonary tuberculosis (pulmonary TB) is a type of infectious disease caused by the bacterium Mycobacterium tuberculosis. A male patient aged 40 years, came to the hospital with complaints of shortness of breath, severe shortness of breath for 1 week before coming to the hospital, the patient had a history of having WSD installed, on palpation the left vocal fremitus was stronger than the right, percussion was found to be dim in the basal area. lung, hyperresonance in the medial-apex area pulmo dextra and sonor on pulmo sinistra, decreased vesicular auscultation in the right lung, chest X-ray found pleural effusion. The patient was treated with air surge therapy. After surgery and evaluated for 4 days in the hospital and repeated follow-up on patients where the results of the examination did not find recurrent effusions.

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“…In the current era, VATS decortication is preferred given similar results in terms of improvement, and superior outcomes in terms of decreased length of stay, morbidity, operative time, post-operative pain and air leaking, duration of chest drainage, and early return to daily activities [ 68 ]. The success rate of VATS is reported to range between 82–92% [ 69 ]. In the General Thoracic Surgery Database, complications occurred in 2875 patients (39.3%) and major morbidity occurred in 1138 patients (15.6%) undergoing VATS.…”

Section: Managementmentioning

confidence: 99%

Infective Pleural Effusions—A Comprehensive Narrative Review Article

Abdulelah,

Abu Hishmeh

2024

Clinics and Practice

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Infective pleural effusions are mainly represented by parapneumonic effusions and empyema. These conditions are a spectrum of pleural diseases that are commonly encountered and carry significant mortality and morbidity rates reaching upwards of 50%. The causative etiology is usually an underlying bacterial pneumonia with the subsequent seeding of the infectious culprit and inflammatory agents to the pleural space leading to an inflammatory response and fibrin deposition. Radiographical evaluation through a CT scan or ultrasound yields high specificity and sensitivity, with features such as septations or pleural thickening indicating worse outcomes. Although microbiological yields from pleural studies are around 56% only, fluid analysis assists in both diagnosis and prognosis by evaluating pH, glucose, and other biomarkers such as lactate dehydrogenase. Management centers around antibiotic therapy for 2–6 weeks and the drainage of the infected pleural space when the effusion is complicated through tube thoracostomies or surgical intervention. Intrapleural enzymatic therapy, used to increase drainage, significantly decreases treatment failure rates, length of hospital stay, and surgical referrals but carries a risk of pleural hemorrhage. This comprehensive review article aims to define and delineate the progression of parapneumonic effusions and empyema as well as discuss pathophysiology, diagnostic, and treatment modalities with aims of broadening the generalist’s understanding of such complex disease by reviewing the most recent and relevant high-quality evidence.

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Video-Assisted Thoracoscopic Surgery of Parapneumonic Empyema – a 10-year Single-Centre Experience

Abstract: A standardised approach, including VATS, is associated with a high cure, low revision and moderate conversion rates. In view of a still considerable mortality, a higher index of suspicion and detection of advanced stages, especially in younger patients, is required to improve outcomes.

Cited by 10 publications

References 19 publications

Pleural Effusion in Adults—Etiology, Diagnosis, and Treatment

Pleural Effusion in Adults—Etiology, Diagnosis, and Treatment

Shortterm Outcome Air Plombage Thoracoplasty of Empyema Thoracis at Pulmonary Tuberculosis

Infective Pleural Effusions—A Comprehensive Narrative Review Article

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