Optimal timing of thoracoscopic drainage and decortication for empyema

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Abstract

Background Although video-assisted thoracic surgery (VATS) pleural drainage and decortication have been proven to be effective treatments in the early stages of empyema, the optimal timing of VATS is still not clear. To assess the effectiveness of early VATS drainage and decortication, we reviewed the records of patients who underwent VATS and open decortication for empyema. Methods One hundred twenty-eight patients with empyema were treated with VATS and open decortication over 8 years at Korea University Anam Hospital. The VATS patients (120 patients) were divided into 3 groups based on the interval between the onset of chest symptoms and the time of operation (group 1: <2 weeks; group 2: 2 to 4 weeks; group 3: >4 weeks). Additional 8 open decortication patients with symptom durations greater than 4 weeks were compared with group 3 patients. Results Groups 1 and 2 showed shorter chest tube duration, postoperative hospital stay, surgical procedure time, and fewer prolonged air leaks than group 3. No significant difference was noted between groups 1 and 2; and no difference was noted in the length of postoperative intensive care unit stays or the reintervention and reoperation rates among the 3 groups. In chronic empyema patients, group 3 showed shorter chest tube duration than the open decortication group. Conclusions Patients with symptom durations of less than 4 weeks showed better early results than those with symptom durations greater than 4 weeks. Thus, symptom duration can be considered a reliable preoperative factor in deciding the surgical management of empyema or cases involving loculated pleural effusion.

Original languageEnglish
Pages (from-to)224-229
Number of pages6
JournalAnnals of Thoracic Surgery
Volume97
Issue number1
DOIs
Publication statusPublished - 2014 Jan 1

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Empyema
Video-Assisted Thoracic Surgery
Drainage
Chest Tubes
Postoperative Care
Pleural Effusion
Korea
Reoperation
Intensive Care Units
Length of Stay
Thorax
Air

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Optimal timing of thoracoscopic drainage and decortication for empyema. / Chung, Jae Ho; Lee, Sung Ho; Kim, Kwang Taik; Jung, Jae-Seung; Son, Ho Sung; Sun, Kyung.

In: Annals of Thoracic Surgery, Vol. 97, No. 1, 01.01.2014, p. 224-229.

Research output: Contribution to journalArticle

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