Video-Thoracoscopic and Open Surgical Management of Thoracic Empyema

Abstract

Many treatment modalities are available for thoracic empyema, depending on the results of appropriate clinical and laboratory investigations. In fibrinopurulent empyema, VATS debridement is safe and effective, with minimal morbidity and no deaths. Lung decortication via thoracotomy is the only option for organized empyema and is associated with a substantial mortality rate.

Interventional Management of Pleural Infections

“…83 Thoracotomy remains the main salvage procedure after unsuccessful thoracoscopy, as defined by the failure of lung expansion to the chest wall. 62,72,84 Performed in appropriate operative candidates, the . A patient with a chronic left-sided empyema and bronchopleural fistula due to recurrent pneumonia underwent drainage of pleural pus with a large-bore chest tube.…”

The role of thoracoscopic debridement in the treatment of parapneumonic empyema

“…Various studies have implied that thoracotomy and open surgery is an acceptable treatment in patients with stage 3 empyema, due to increased technical failure of VATS. 1,5,11 However, the results of VATS in this phase have also been reported. Studies comparing VATS to open surgery in patients with chronic empyema (stage 3) found less postoperative chest drainage, shorter hospital stay, less pain after the operation, and earlier mobilization after VATS.…”

Comparison of video-assisted thoracoscopic surgery and open surgery in the management of primary empyema

“…Initially VATS was used for diagnostic purposes and confirmed the presence of empyema [6]. Later VATS debridement was found to be a very effective method of treating early fibrinopurulent empyema [7,8]. The reduced morbidity and more pleasing aesthetics associated with a VATS approach generated great interest in the procedure.…”