Surgical management of acute empyema

When should a thoracoscopic approach be selected?

Abstract

Thoracoscopic debridement was successfully performed in five patients with acute empyema. Postoperative course was good in all patients, and no recurrence of empyema was observed. VATS debridement was thought to be an effective means of providing complete drainage and breakdown of loculations, especially in the fibrinopurulent phase. By choosing appropriate timing of the operation, thoracoscopic debridement can be done safely even in those patients who have significant comorbid conditions. Early aggressive surgical approach using thoracoscopy may allow shortening of the hospital stay, and will prevent development as chronic empyema.