Video-Assisted Thoracoscopic Surgery in the Treatment of Chronic Empyema Thoracis

Background: Video-assisted thoracoscopic surgery (VATS) is widely used for the treatment of empyema. We evaluated clinical symptoms, laboratory examinations, and thoracentesis to assess patients in the emergency department (ED) with empyema thoracis, undergoing VATS to identify predictors of adverse outcomes. Methods: This retrospective study was conducted by reviewing records of ED patients with pleural empyema admitted for VATS from January 2007 to June 2014. Demographic data, clinical symptoms, and laboratory examinations were compared for survivors (Group I) and non-survivors (Group II). Logistic regression analysis was used to identify parameters related to postoperative mortality. Results: From 380 patients, 7.6% (n = 29) died postoperatively. Survivors and non-survivors exhibited differences in age, gender, presence of cough, dyspnea, chest pain, empyema stage, cerebrovascular disease, malignancy, the glucose level of pleural fluid, serum hemoglobin, platelet count, blood urea nitrogen, and potassium levels. The logistic analysis demonstrated that the most significant factor related to the postoperative morbidity is chest pain (p = 0.018). Conclusions: VATS could be a safe option for pediatric and geriatric patients. Age does not appear to affect postoperative mortality. A high degree of awareness is essential for perioperative management and early surgical treatment when ED patients present with the clinical symptom of chest pain.

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VATS thoracoscopic decortication for empyema thoracic. A retrospective experience and analysis of 162 cases

Journal of the Pakistan Medical Association ◽

10.47391/jpma.431 ◽

2020 ◽

pp. 1-10

Author(s):

Farhan Ahmad Majeed ◽

Sohail Saqib Chatha ◽

Usama Zafar ◽

Ahmad Ali ◽

Nabeela Farhan ◽

...

Keyword(s):

Retrospective Study ◽

Surgical Site Infection ◽

Thoracoscopic Surgery ◽

Site Infection ◽

Empyema Thoracis ◽

Efficient Procedure ◽

Military Hospitals ◽

Video Assisted ◽

Post Procedure ◽

Video Assisted Thoracoscopic Surgery

Abstract Objective: To analyse the experience of empyema thoracis management using video-assisted thoracoscopic surgery. Method: The retrospective study was conducted at the Combined Military Hospitals, Rawalpindi and Lahore, Pakistan, and comprised data of empyema thoracis cases who underwent thoracoscopic decortications by the same consultant surgeon between January 2009 and 2018. Uniportal or multiportal video-assisted thoracoscopic decortications was done. Histopathology and microbiological sampling were done in all cases. Results: of the 162 cases, 114(70.4%) were done on males and 48(29.6%) on females. The overall mean age was 44±16.37 years. Three ports were utilised in 58(36%) patients. Hospital stay of 122(75.3%) patients was <5 days post-procedure. Post-thoracotomy neuralgia occurred in 19(11.7%) patients, while 9(5.5%) had surgical site infection. Overall complications were 30(18.5%). There was no mortality. Conclusion: Video-assisted thoracoscopic decortications was found to be a safe, effective and efficient procedure. Key Words: VATS, Decortication, Empyema thoracis. Continuous...

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Remarks on indication and results of video assisted-thoracoscopic surgery for empyema

Vietnam Journal of Endolaparoscopic Surgery ◽

10.51199/vjsel.2020.3.5 ◽

2020 ◽

Vol 10 (3) ◽

Author(s):

Anh Hải Vũ ◽

Keyword(s):

Pathogenic Bacteria ◽

Thoracoscopic Surgery ◽

Military Hospital ◽

Karnofsky Score ◽

Video Assisted ◽

Chronic Empyema ◽

Study Results ◽

The Mean ◽

End Stage ◽

Video Assisted Thoracoscopic Surgery

Tóm tắt Mục tiêu: Nhận xét chỉ định và kết quả ứng dụng phẫu thuật nội soi (PTNS) trong điều trị mủ màng phổi. Đối tượng và phương pháp: 44 người bệnh mủ màng phổi giai đoạn bán cấp và mạn tính được PTNS điều trị tại khoa phẫu thuật lồng ngực - Bệnh viện Quân Y 103, thời gian từ 01/2017 đến 04/2019. Nghiên cứu tiến cứu, mô tả và theo dõi dọc. Kết quả: Tuối trung bình 54,6 ± 14,2; tỷ lệ nam/nữ là 21/1; điểm Karnofsky 68,6 ± 6,9; bệnh lý kết hợp gồm: đái tháo đường (36,4%), suy thận giai đoạn cuối (2,3%), xơ gan (2,3%). Cấy khuẩn mủ màng phổi xác định được vi khuẩn gây bệnh ở 12/44 trường hợp (tỷ lệ 27,3%); PTNS điều trị mủ màng phổi giai đoạn bán cấp tính chiếm 77,3%, mạn tính 22,7%. Phương pháp xử lý gồm: bóc vỏ phổi (56,8%) và gỡ dính, hút mủ, rửa màng phổi, dẫn lưu kín (43,2%); Biến chứng sau mổ 9,1%. Kết quả tốt tại thời điểm 1 và 3 tháng sau phẫu thuật lần lượt là 43,2% và 81,8%. Kết luận: Ứng dụng PTNS điều trị mủ màng phổi (MMP) giai đoạn bán cấp và đầu mạn tính khả thi. Biến chứng tỷ lệ thấp (9,1%). Kết quả tốt khả quan tại thời điểm tháng thứ 3 sau phẫu thuật (81,8%). Abstract Objectives: Remarks on indication and results of Video - Assisted - Thoracoscopic Surgery (VATS) for management of empyema. Materials and Methods: 44 patients with fibrinopurulent and empyema phases were treated by VATS at the Department of thoracic surgery of Military Hospital 103, from 01/2017 to 04/2019. Descriptive, longitudinal and prospective study. Results: The mean of age was 54.6 ± 14.2; male/female was 21/1; Karnofsky score was 68.6 ± 6.9; Comorbidity diseases include: diabetes (36.4%), end-stage renal failure (2.3%), cirrhosis (2.3%). Results of pleural pus culture with 12/44 (27,3%) were identified pathogenic bacteria. VATS performed for fibrinopurulent and chronic empyema (77.3% and 22.7%, respectively). The techniques performed were: decortication (56.8%) and empyemectomy and debridement (43.2%). The rate of postoperative complication was relative low (9.1%). The good results at the 1st and 3rd month after surgery were 43.2% and 81.8%, respectively. Conclusion: Application of VATS for fibrinopurulent and chronic empyema was feasibility. Low-rate of complication was only 9,1%. The good results at the 3rd month after surgery was as high as 81,8%. Keywords: Empyema; Video-Assisted-Thoracoscopic Surgery

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Uniportal thoracoscopic surgery for difficult late stage empyema: Case series

Journal of Emergency Medicine Trauma and Acute Care ◽

10.5339/jemtac.2021.2 ◽

2021 ◽

Vol 2021 (1) ◽

Author(s):

Klein Dantis

Keyword(s):

Methicillin Resistant Staphylococcus Aureus ◽

Thoracoscopic Surgery ◽

Case Series ◽

Open Approach ◽

Open Thoracotomy ◽

Invasive Approach ◽

Video Assisted ◽

Chronic Empyema ◽

Clinical Scenarios ◽

Video Assisted Thoracoscopic Surgery

Early, aggressive, and minimally invasive approach is an advanced surgical approach for chronic empyema management. The traditional video-assisted technique is considered superior over open thoracotomy for empyema management; however, with further modification, the uniportal video-assisted thoracoscopic surgery (UVATS) has greater advantage for surgeons, providing better anatomical view of target tissues, allowing bimanual instrumentation similar to open approach, and nullifying the creation of dihedral angle by instruments that are not favorable in traditional VATS. The present case series describes different clinical scenarios including chronic empyema secondary to traumatic hemothorax, recurrent tubercular empyema following postoperative open decortication, and methicillin-resistant staphylococcus aureus chronic empyema in pediatric patient, which are effectively managed with UVATS approach.

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Results of Application of Video-Assisted Thoracoscopic Surgery for the Treatment of Empyema Thoracis

Tuberculosis and Respiratory Diseases ◽

10.4046/trd.2006.61.5.463 ◽

2006 ◽

Vol 61 (5) ◽

pp. 463 ◽

Cited By ~ 1

Author(s):

Gi Hoon Choi ◽

Goang Min Choi ◽

Hyoung Soo Kim ◽

Seong Joon Cho ◽

Se Min Ryu ◽

...

Keyword(s):

Thoracoscopic Surgery ◽

Empyema Thoracis ◽

Video Assisted ◽

Video Assisted Thoracoscopic Surgery

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Video-Assisted Thoracoscopic Surgery (VATS) in a 20-Day-Old Newborn With Empyema Thoracis

Indian Pediatrics ◽

10.1007/s13312-021-2174-x ◽

2021 ◽

Vol 58 (3) ◽

pp. 284-285

Author(s):

Yogendra Sanghvi ◽

Rajesh Kewlani ◽

Avinash Walawalkar ◽

Neemish Kamat ◽

Suresh Birajdar

Keyword(s):

Thoracoscopic Surgery ◽

Empyema Thoracis ◽

Video Assisted ◽

Video Assisted Thoracoscopic Surgery

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Paediatric empyema: video-assisted thoracoscopic surgery (vats) and its outcome study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20171691 ◽

2017 ◽

Vol 4 (3) ◽

pp. 882

Author(s):

Manasa G. ◽

Swetha B. ◽

Yashoda H. T. ◽

Pramod S.

Keyword(s):

Chest Pain ◽

Respiratory Distress ◽

Thoracoscopic Surgery ◽

Supplemental Oxygen ◽

Empyema Thoracis ◽

Chest Tubes ◽

Female Ratio ◽

Duration Of Stay ◽

Video Assisted ◽

Video Assisted Thoracoscopic Surgery

Background: Empyema thoracis defined as purulent pleural effusion is a common condition in children with significant morbidity and mortality. The aim of therapy for empyema is to ensure rapid recovery with a normal long term pulmonary outcome. VATS (Video-assisted thoracoscopic surgery) is gaining acceptance as a primary modality of treatment in cases of early empyema. VATS is associated with decreased morbidity and reduced hospital stay of the patient. Methods: This is a retrospective observational study conducted in the department of pediatrics KIMS Hospital, Bengaluru from November 2014 to November 2016. In this study, review of the medical records of all the children aged 2 months to 18 years, who underwent VATS for empyema was done. The children included in the study were diagnosed with empyema thoracis based on chest X- ray, USG chest and CT chest and have undergone VATS by pediatric surgical team. Results: The median age of presentation was 4.1 yrs. 18 children were malnourished of which 3 had severe malnutrition. Male to female ratio was 1:1. Most common symptoms were fever (96%), cough (84%), respiratory distress (61%) and chest pain (48%). All patients had parapneumonic effusions and received antibiotics before undergoing surgery. Post-operative supplemental oxygen was required for 2.5±0.5 days. Chest tubes were removed in 4.53±0.7days and duration of stay in hospital was 8.26±1.77 days. All patients were afebrile before discharge and were discharged on oral antibiotics. Follow-up data showed that symptoms resolved in 24 children, 2 children had complications, one child had a pneumothorax and another had a broncho-pleural fistula. Results: Most common symptoms were fever (96%), cough (84%), respiratory distress (61%) and chest pain (48%). All patients had parapneumonic effusions and received antibiotics before undergoing surgery. Post-operative supplemental oxygen was required for 2.5±0.5 days. Chest tubes were removed in 4.53±0.7days and duration of stay in hospital was 8.26±1.77 days. All patients were afebrile before discharge and were discharged on oral antibiotics.Conclusions: These results suggest that primary operative therapy in the form of VATS is an effective treatment option for children with empyema. VATS is associated with a lower in-hospital mortality rate, re-intervention rate, length of stay and duration of tube thoracostomy.

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