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The Egyptian Journal of Bronchology
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Evaluation of the role of video - assisted thoracoscopic surgery in management of empyema

Egyptian Journal of Bronchology volume 12, pages 419–426 (2018)Cite this article

Abstract

Background

Video-assisted thoracoscopic surgery (VATS) is effective for fibropurulent thoracic empyema and less invasive, and it may be important as a bridge between minimally invasive and conventional open thoracic surgical management.

Aim

The aim of this study was to determine the optimal treatment of parapneumonic effusion in the fibrinopurulent stage comparing blind thoracostomy versus VATS with regard to efficacy, duration of hospitalization and intercostal tube (ICT) insertion, and need for further surgery or not.

Patients and methods

This study was a prospective comparative randomized study conducted on 60 patients with confirmed parapneumonic effusion where they were classified into two groups. The blind thoracostomy group: 30 patients underwent blind thoracostomy and the VATS group: 30 patients underwent VATS.

Results

The incidence of clinical improvement was more in the VATS group when compared to the blind thoracostomy group. The hospital outcome in the VATS group was much better than in the blind group, where in the VATS group, the postoperative length of hospital stay was around 4.8 days and the time of ICT removal was after 5 days from insertion, whereas in the blind group, the length of hospital stay was around 9.7 days and the time of ICT removal was after about 6 days of insertion. The incidence of postoperative complications was higher in the blind group than in the VATS group.

Conclusion

VATS provides more accurate staging for parapneumonic effusion, an excellent surgical view for a complicated empyema cavity, thus making it possible to perform a sufficient evacuation of all empyema membranes.

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Authors and Affiliations

  1. Department of Chest Diseases, Faculty of Medicine Ain Shams University, 15 AbdelHalim Nwera Street, 11843, New Nozha, Cairo, Egypt

    Mohammed Ali Farrag, Nevine Mohamed Mohamed Abd ELfattah, Eman Badawy Abd ElFattah MD Degree of Pulmonary Medicine & Mahmoud Mohsen Mahmoud Khalil

  2. Department of Cardiothoracic Surgery, Faculty of Medicine Ain Shams University, Cairo, Egypt

    Hatem Yazed Al Bawab

Authors
  1. Mohammed Ali Farrag
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  2. Hatem Yazed Al Bawab
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  3. Nevine Mohamed Mohamed Abd ELfattah
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  4. Eman Badawy Abd ElFattah MD Degree of Pulmonary Medicine
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  5. Mahmoud Mohsen Mahmoud Khalil
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Corresponding author

Correspondence to Eman Badawy Abd ElFattah MD Degree of Pulmonary Medicine.

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Farrag, M.A., Al Bawab, H.Y., Mohamed Abd ELfattah, N.M. et al. Evaluation of the role of video - assisted thoracoscopic surgery in management of empyema. Egypt J Bronchol 12, 419–426 (2018). https://doi.org/10.4103/ejb.ejb_23_18

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  • DOI: https://doi.org/10.4103/ejb.ejb_23_18

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