BENEFITS OF EARLY AGGRESSIVE MANAGEMENT OF EMPYEMA THORACIS

• Published in: ANZ journal of surgery 2006-03, Vol.76 (3), p.120-122
• Main Authors: Bilgin, Mehmet, Akcali, Yigit, Oguzkaya, Fahri
• Format: Article
• Language: English
• Subjects: Adult; Aged; decortication; empyema; Empyema, Pleural - diagnostic imaging; Empyema, Pleural - microbiology; Empyema, Pleural - surgery; Female; Humans; Length of Stay; Male; Middle Aged; Prospective Studies; Thoracic Surgery, Video-Assisted; thoracoscopy; Tomography, X-Ray Computed; Treatment Outcome; tube thoracostomy
• ISSN: 1445-1433; 1445-2197
• DOI: 10.1111/j.1445-2197.2006.03666.x

Background:  The end‐target of the management of thoracic empyema is to obtain early rehabilitation by re‐expansion of the trapped lung resulting from intrapleural infected material. Our aim was to shorten the hospitalization time and to prevent a possible thoracotomy by using video‐assisted thoracoscopy initially. Methods:  Seventy patients with parapneumonic empyema were prospectively studied between January 1997 and June 2004. The patients were randomly divided into two groups. In group I (n = 35 patients), a chest tube was inserted into the patients after pleural content was evacuated and fibrins were debrided using video‐assisted thoracoscopy. In group II (n = 35 patients), tube thoracostomy was carried out without using a video‐assisted thoracoscope. Both groups were compared in terms of hospitalization time, open surgery for decortication and complications. Results:  There was no statistically significant difference between the groups from the point of view of age and sex (P > 0.05). In group I, 17.1% of the patients underwent open decortication, whereas in group II, 37.1% of the patients underwent the same procedure (P