Publication: Video-Thoracoscopic Management of Empyema Thoracis in tertiary level thoracic unit
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Date
2013
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Journal Title
Journal ISSN
Volume Title
Publisher
Institute of Medicine
Abstract
Abstract
Introduction: Thoracic empyema is a common problem. Use of minimal access surgery for the treatment is comparatively new. We audited our results with VATS in thoracic empyema.
Methods: We analyzed the retrospective data from the patients who received Video-Assisted Thoracoscopic Surgery (VATS) for empyema thoracis from April 2011 to April 2013 at Manmohan Cardio-thoracic Vascular and Transplant Center (MCVTC).
Results: Of the 44 patients who underwent surgery for empyema of various stages, 37 patients underwent the procedure via VATS. The average age was 26.4 ±17.19 yrs (1-64). The male to female ratio was 2:1. The duration of symptoms before VATS intervention varied very widely (7-712 days avg: 92.7±28.8 days). The duration was 32 days on an average among patients in whom deloculation sufficed but was 111 days among those in whom decortication was required. A complete VATS procedure with satisfactory lung expansion at the end of the procedure was possible in 34 patients (100% patients who underwent deloculation and 88% of those who underwent decortications). Inadequate lung expansion forced conversion in three and subsequent collapse necessitated re-operation in one. The operative times were: VATS converted to open decortication (150 mins), completed VATS decortication (60-180 mins, avg: 125.7 mins) and VATS deloculation (45-120 mins, avg: 69 mins). Post-operative chest tube drainage was shorter in patients in whom a successful VATS procedure was completed 4.0 Vs 40 days).
Conclusion: Videothoracoscopic approach is feasible in surgical management of empyema thoracis. The results seem to be better in earlier stages.
Keywords: Deloculation, decortication, empyema, Video-assisted thoracoscopic Surgery (VATS)
Description
UK Shrestha
Manmohan Cardio-thoracic Vascular and Transplant Center, Institute of Medicine, Tribhuvan University
B Thapa
Manmohan Cardio-thoracic Vascular and Transplant Center, Institute of Medicine, Tribhuvan University
R Baral
Manmohan Cardio-thoracic Vascular and Transplant Center, Institute of Medicine, Tribhuvan University
R Sapkota
Manmohan Cardio-thoracic Vascular and Transplant Center, Institute of Medicine, Tribhuvan University
P Sayami
Manmohan Cardio-thoracic Vascular and Transplant Center, Institute of Medicine, Tribhuvan University
Keywords
Deloculation, decortication, empyema, Video-assisted thoracoscopic Surgery (VATS)