Abstract
Video-assisted thoracoscopic surgery for acute empyema is less-invasive, and its safety has been emphasized in many reports. With the expansion of indications, however, it has been suggested that the incidences of complications and death are high in patients with a poor general condition. During the three years from January 2011, we performed thoracoscopic surgery for acute empyema after pneumonia in 35 patients. Among them, 10 patients (29%) experienced postoperative complications, and there were 3 cases (8.6%) of in-hospital mortality. The results of our examination of the preoperative factors affecting postoperative complications showed that the minimum preoperative serum albumin value in the group with complications, 2.4±0.4 g/dL, was significantly lower than that in the group without complications, 2.9±0.6 g/dL (p=0.012), and that patients with a performance status (PS) of 3-4 experienced complications more frequently than those with a PS of 0-2 (p=0.002). In a receiver operating characteristic (ROC) curve analysis, a cutoff value for albumin of 2.5 g/dL or less demonstrated a sensitivity of 84% and specificity of 80% for predicting the development of complications. It was considered that we should judge the risk groups for complications before surgery and consider appropriate therapeutic strategies in the future.
