| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1998;65:319-323
© 1998 The Society of Thoracic Surgeons
Department of Thoracic and Cardiovascular Surgery, University of Bern, Inselspital, Bern, Switzerland,
Department of Pulmonary Medicine, University of Bern, Inselspital, Bern, Switzerland,
Department of Internal Medicine, University of Bern, Inselspital, Bern, Switzerland
Accepted for publication August 2, 1997.
Dr Ris, Department of Thoracic and Cardiovascular Surgery, Inselspital, 3010 Bern, Switzerland.
Background. The roles of different drainage procedures in the management of empyema have to be redefined now that video-assisted thoracoscopic surgery (VATS) has been introduced. The debridement of fibrinopurulent stage II empyema with the use of VATS was assessed prospectively in regard to control of infection and restoration of pulmonary function.
Methods. Between January 1992 and May 1996, all patients at our institution with fibrinopurulent empyema that did not respond to chest tube drainage and antibiotic therapy were treated by debridement with the use of VATS. The patients were followed up prospectively by clinical and radiologic assessments 3 and 6 months after the operation and by spirometry 6 months after the operation.
Results. Video-assisted thoracoscopic surgery was initiated in 67 patients, but conversion to open decortication was required because of the finding of advanced disease in 19 patients (28%). Forty-eight patients underwent successful debridement with the use of VATS. The mean operative time was 82.1 minutes (range, 50 to 135 minutes), the mean duration of postoperative chest tube placement was 4.1 days (range, 2 to 8 days), and the mean duration of postoperative hospitalization was 12.3 days (range, 4 to 42 days). No wound infections were observed during the postoperative course. Both the 30-day mortality rate and the recurrence (ie, need for thoracotomy) rate were 4%. The mean predicted vital capacity was 84.8% ± 14.9% and the mean predicted forced expiratory volume in 1 second was 88.6% ± 19.2% 6 months after the operation.
Conclusions. Debridement with the use of VATS is safe and efficient for stage II empyema, but open decortication should be used for more advanced disease.
This article has been cited by other articles:
|
|
 |
|
  C. Casali, E. Susanna Storelli, E. Di Prima, and U. Morandi Long-term functional results after surgical treatment of parapneumonic thoracic empyema Interactive CardioVascular and Thoracic Surgery, July 1, 2009; 9(1): 74 - 78. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Boffa, D. P. Mason, J. W. Su, S. C. Murthy, J. Feng, A. M. McNeill, M. M. Budev, A. C. Mehta, and G. B. Pettersson Decortication After Lung Transplantation Ann. Thorac. Surg., March 1, 2008; 85(3): 1039 - 1043. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. T.L. Chan, A. D.L. Sihoe, S. Chan, D. S.F. Tsang, B. Fang, T.-W. Lee, and L.-C. Cheng Surgical Treatment for Empyema Thoracis: Is Video-Assisted Thoracic Surgery "Better" Than Thoracotomy? Ann. Thorac. Surg., July 1, 2007; 84(1): 225 - 231. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H.-B. Ris and T. Krueger Video-assisted thoracoscopic surgery and open decortication for pleural empyema MMCTS, January 9, 2006; 2006(0109): 273. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. N. Wurnig, V. Wittmer, N. S. Pridun, and P. H. Hollaus Video-Assisted Thoracic Surgery for Pleural Empyema Ann. Thorac. Surg., January 1, 2006; 81(1): 309 - 313. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. W. Light Parapneumonic effusions and empyema. Proceedings of the ATS, January 1, 2006; 3(1): 75 - 80. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. H. Brutsche, G.-F. Tassi, S. Gyorik, M. Gokcimen, C. Renard, G. P. Marchetti, and J.-M. Tschopp Treatment of Sonographically Stratified Multiloculated Thoracic Empyema by Medical Thoracoscopy Chest, November 1, 2005; 128(5): 3303 - 3309. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Lardinois, M. Gock, E. Pezzetta, C. Buchli, V. Rousson, M. Furrer, and H.-B. Ris Delayed Referral and Gram-Negative Organisms Increase the Conversion Thoracotomy Rate in Patients Undergoing Video-Assisted Thoracoscopic Surgery for Empyema Ann. Thorac. Surg., June 1, 2005; 79(6): 1851 - 1856. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Mennander, J. Laurikka, P. Kuukasjarvi, and M. Tarkka Continuous pleural lavage may decrease postoperative morbidity in patients undergoing thoracotomy for stage 2 thoracic empyema Eur. J. Cardiothorac. Surg., January 1, 2005; 27(1): 32 - 34. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Roberts Minimally invasive surgery in the treatment of empyema: intraoperative decision making Ann. Thorac. Surg., July 1, 2003; 76(1): 225 - 230. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. Waller and A. Rengarajan Thoracoscopic decortication: a role for video-assisted surgery in chronic postpneumonic pleural empyema Ann. Thorac. Surg., June 1, 2001; 71(6): 1813 - 1816. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. P.C. Yim Paradigm Shift in Empyema Management Chest, March 1, 1999; 115(3): 611 - 612. [Full Text] [PDF]
|
|
|
|
 |
|
 P. C. Cassina, M. Hauser, L. Hillejan, D. Greschuchna, and G. Stamatis VIDEO-ASSISTED THORACOSCOPY IN THE TREATMENT OF PLEURAL EMPYEMA: STAGE-BASED MANAGEMENT AND OUTCOME J. Thorac. Cardiovasc. Surg., February 1, 1999; 117(2): 234 - 238. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
