The role of thoracoscopic debridement in the treatment of parapneumonic empyema. (August 2013)

• Record Type: Journal Article
• Authors: Bagheri, Reza; Tavassoli, Alireza; Haghi, Seyed Ziaollah; Attaran, Davoud; Sadrizadeh, Ali; Asnaashari, Amir; Basiri, Reza; Salehi, Maryam; Moghadam, Kamran Adhami; Tabari, Azadeh; Sheibani, Shima
• Is Part Of: Asian cardiovascular & thoracic annals. Volume 21:Number 4(2013)
• Page Start: 443
• Page End: 446
• Publication Date: 2013-08
• Subjects: Anti-bacterial agents -- blood loss -- surgical -- drainage -- empyema -- pleural -- thoracic surgery -- video-assisted; Heart -- Diseases -- Asia -- Periodicals; Heart -- Diseases -- Pacific Area -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Surgery -- Asia -- Periodicals; Heart -- Surgery -- Pacific Area -- Periodicals; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Asia -- Periodicals; Chest -- Surgery -- Pacific Area -- Periodicals; Chest -- Surgery -- Periodicals; 617.412
• DOI: 10.1177/0218492312466858
• Languages: English
• ISSNs: 0218-4923

Abstract

Aim: To evaluate the efficacy of early video-assisted thoracoscopic debridement in patients with the fibropurulent phase of parapneumonic empyema. Patients and methods: 40 patients with parapneumonic empyema resistant to 2 weeks of antibiotic therapy, were randomly divided into 2 groups. In group 1 (20 patients), antibiotic therapy and irrigation was continued, and in group 2 (20 patients), video-assisted thoracoscopic debridement was performed. The 2 groups were compared in terms of therapeutic results. Results: The male/female ratio was 29/11. Group 1 included 16 men and 4 women with a mean age of 54 years, and mean hospital stay was 41 days. Group 2 consisted of 14 men and 6 women with a mean age of 51 years, and mean hospital stay was 23 days. Considering the therapeutic results, 12 patients in group 1 were cured by antibiotic therapy and irrigation, whereas 8 required decortication and pleurectomy with thoracotomy. In group 2, 18 patients were cured by video-assisted thoracoscopic debridement, and 2 underwent thoracotomy and decortication due to intraoperative bleeding. A significant difference in therapeutic results was noted between the groups ( p = 0.028). Conclusion: Video-assisted thoracoscopic debridement provides a high success rate and less invasive treatment for the early stages of empyema.