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Video-Assisted Thoracoscopic Decortication for management of Postpneumonia Empyema  

김보영 (상무병원 흉부외과)
오봉석 (전남대학교 외과대학, 흉부외과학 교실)
양기완 (전남대학교 외과대학, 흉부외과학 교실)
임진수 (조선대학교병원 흉부외과)
서홍주 (조선대학교병원 흉부외과)
박종철 (현대병원 내과)
Publication Information
Journal of Chest Surgery / v.36, no.1, 2003 , pp. 21-25 More about this Journal
Abstract
Video-assisted thoracoscopic surgery (VATS) for decortication or debridement in the management of empyema thoracis has increased the available treatment options but requires validation. We present and evaluate our technique and experience with thoracoscopic management of pleural empyema, irrespective of chronicity. Material and Method : VATS debridement or decortication was performed with endoscopic shaver system in 40 consecutive patients presented with pleural space infections. A retrospective review was performed and the effect of this technique on perioperative outcome was assessed. Result : VATS evacuation of infected pleural fluid and decortication was successfully performed in 35 of 40 patients. The mean duration of preoperative symptoms before referral was 23$\pm$1.8 days. The mean duration of hospitalization before transfer was 13.5$\pm$1.5 days. Blood loss was 250 to 200 mL. Intercostal drainage was required for 5$\pm$3 days. The postoperative hospital stay was 5 $\pm$0.7 days. There were no operative mortalities. Conclusion : Video-assisted evacuation of infected pleural fluid and decortication is an effective modality in the management of the fibropurulent stage of empyema. An organized empyema should be approached thoracosco-pically, but may require open decortication.
Keywords
Thoracoscopy; Empyema; Decorcation;
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