Video-assisted thoracoscopic surgery for acute empyema

Abstract

The primary treatment of acute empyema is to re-expand the collapsed lung as fully as possible, perform drainage and administer antibiotics. Debridement and drainage using video-assisted thoracic surgery (VATS) with minithoracotomy were successfully performed in five patients with acute empyema that did not respond to thoracic drainage, antibiotic therapy and/or irrigation. The mean duration of preoperative symptoms was 16 days (range, 3 to 43 days), and the mean duration of preoperative drainage was 7 days (range, 1 to 14 days). Five patients underwent successful debridement, irrigation and drainage with the use of VATS. The mean operative time and intraoperative blood loss were 90 minutes and 265 g, respectively. Postoperative course was good in all patients . The mean duration of postoperative drainage was 11 days (range, 8 to 18 days) and the mean duration of postoperative hospitalization was 19 days (range, 14 to 27 days). Debridment with the use of VATS is safe and efficient for acute empyema with persistent inflammation and insufficient re-expansion of lung.