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Asian Cardiovasc Thorac Ann. 2013 Aug;21(4):443-6. doi: 10.1177/0218492312466858. Epub 2013 Jul 11.

The role of thoracoscopic debridement in the treatment of parapneumonic empyema.

Author information

1
Cardiothoracic Surgery & Transplant Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

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 (pā€‰=ā€‰0.028).

CONCLUSION:

Video-assisted thoracoscopic debridement provides a high success rate and less invasive treatment for the early stages of empyema.

KEYWORDS:

Anti-bacterial agents; blood loss; drainage; empyema; pleural; surgical; thoracic surgery; video-assisted

PMID:
24570527
DOI:
10.1177/0218492312466858
[Indexed for MEDLINE]

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