Safety and efficacy of medical thoracoscopy in the management of loculated thoracic empyema

Abo-El-maged, Ahmed Hassan Ali; Elsamadony, Mohamed Fahmy; Elshamly, Mousa; Hablas, Wael R.

doi:10.1016/j.ejcdt.2016.12.013

Cited by 5 publications

(15 citation statements)

References 22 publications

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“…The articles describe studies carried out between 1989 [ 11 ] and 2016 [ 15 , 17 ]. They were published between 1997 [ 10 ] and 2018 [ 17 ] (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…The following countries were involved in the selected studies: Switzerland (2, 22.2%) [ 10 , 11 ], Italy (2, 22.2%)[ 11 , 12 ], Japan (1, 11.1%) [ 13 ], China (1, 11.1%) [ 14 ], Egypt (1, 11.1%) [ 15 ], UK (1, 11.1%) [ 16 ], Greece (1, 11.1%)[ 16 ], and Pakistan (1, 11.1%)[ 17 ]. Studies were mono-center in most of the cases (6, 66.7%) [ 10 , 12 – 15 , 17 ], whereas multi-center in only two (25%)[ 10 , 16 ] studies. Three (33.3%) [ 10 , 13 , 17 ] case-series recruiting ≥ 10 patients were selected; five (62.5%) [ 11 , 12 , 14 – 16 ] studies were observational and retrospective, without providing further epidemiological details.…”

Section: Resultsmentioning

confidence: 99%

“…Sample size of the selected studies ranged from 16 [ 10 ] to 430 [ 14 ] patients (Table 1 ). The majority of the studies (7, 77.8%) [ 10 , 12 , 13 , 15 – 17 ] described the use of thoracoscopy for the management of empyema, whereas one article described this scope of thoracoscopy only in 15.1% [ 14 ] of their patients.…”

Section: Resultsmentioning

confidence: 99%

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Medical thoracoscopy treatment for pleural infections: a systematic review and meta-analysis

et al. 2021

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Background Complicated parapneumonic effusions and empyema represent advanced stages of pleural infections and are characterized by a high mortality. Medical thoracoscopy is a safe and minimally invasive endoscopic technique prescribed to treat severe pleural infections. However, only a few studies evaluated its success rate. A systematic review of observational studies was performed to assess the efficacy of medical thoracoscopy in patients with complicated parapneumonic effusions and empyema, as well as its predictive factors. Methods A search of the scientific evidence was carried out using PubMed, EMBASE, and Cochrane Central Register of Controlled Trials. Articles describing observational studies on medical thoracoscopy in patients with parapneumonic effusions and empyema were selected. Results Eight studies met the inclusion criteria. The pooled treatment success rate of thoracoscopy was 85% (95% CI 80.0–90.0%; I2: 61.8%) when used as first-line intervention or after failure of chest tube. The pooled complication rate was 9.0% (95% CI 6.0–14.0%; I2: 58.8%). A pooled difference of treatment success of 9.0% (95% CI 1.0–18.0%) was found when post-thoracoscopy intra-pleural fibrinolysis was prescribed. Pooled success rate was higher in cases with pleural fluid culture negativity (pooled difference: 14.0%; 95% CI 4.0–24.0%). Conclusions Medical thoracoscopy is effective and safe when prescribed for complicated parapneumonic effusions and empyema. Bacteriological negativity of pleural effusion specimens and administration of adjuvant intra-pleural fibrinolysis after the procedure are associated with a higher success rate.

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“…The articles describe studies carried out between 1989 [ 11 ] and 2016 [ 15 , 17 ]. They were published between 1997 [ 10 ] and 2018 [ 17 ] (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Medical thoracoscopy treatment for pleural infections: a systematic review and meta-analysis

et al. 2021

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“…Keadaan empiema menjadi perburukan sebanyak 86,7% dari seluruh kasus empiema dengan tata laksana pembedahan yaitu 10% membaik dengan tindakan dekortikasi dan 3,3% membik dengan tindakan pembedahan penutupan fistula. 5 Empiema dapat terjadi pada segala usia yang mayoritas terjadi pada orang tua. Mortalitas empiema berkisar antara 1% hingga 19%.…”

Section: Pendahuluanunclassified

Problem Terapeutik pada Empiema Terlokulasi karena Tuberkulosis

Marhana

Anggraeni

2020

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Background: Pleural effusion is the most common complication of pulmonary tuberculosis (TB). Some coexist with secondary infection could worsen clinical presentation as empyema. The incidence of pleural effusion in the early stage of empyema due to TB infection is about 31%. Somehow, untreated empyema increased in-hospital mortality. Case: A woman with unregulated diabetes mellitus was referred with organized empyema. The etiology of empyema is based on a specific process of TB infection with the ADA value of empyema fluid was 128 mg/dl. We decided to perform decortication with the result loculated empyema and bronchopleural fistula 2 cm in the inferior lobe of the right lung. The patient did not recover well. Unfortunately, fluidopneumothorax was found on a chest CT scan with contrast. Thoracotomy was performed and another bronchopleural fistula was found which length was about 1 cm in superior lobe of the right lung. Discussion: The worsening condition of the patient was caused by the occurrence of postoperative bronchopleural fistula. It was visualized as pulmonary TB with perforation of cavity nessessity. On the other hand, the condition could be worsened by the hyperglycemic state in an immunocompromised individual. Summary: Loculated empyema is a condition caused by bronchopleural fistula, the presence of a connecting cavity between pleural and bronchus which occurred less than 48 hours. Local and systemic factors might explain the development of bronchopleural fistula. Well management of the loculated empyema by knowing the etiology could improve the life survival of the patient.

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Infectious Pleural Effusion

Casalini

2023

Practical Manual of Pleural Pathology

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Safety and efficacy of medical thoracoscopy in the management of loculated thoracic empyema

Cited by 5 publications

References 22 publications

Medical thoracoscopy treatment for pleural infections: a systematic review and meta-analysis

Medical thoracoscopy treatment for pleural infections: a systematic review and meta-analysis

Problem Terapeutik pada Empiema Terlokulasi karena Tuberkulosis

Infectious Pleural Effusion

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