Video-assisted thoracoscopic treatment of pleural empyema *1A new therapeutic approach

Striffeler, H; Hb, Ris; Hu, Würsten; Vi, Hof; Stirnemann, P; Althaus, U

doi:10.1016/1010-7940(94)90040-x

Cited by 27 publications

(18 citation statements)

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“…VATS intervention is reducing the frequency with which open surgery is needed; however, the exact role of this procedure is currently unclear [1,8,10,13,17,22,25,27,28]. It is noteworthy that in recently published series the overall success rate for VATS in cases of pleural empyema is ∼ 77% [1,8,13,27,28,30].…”

Section: Discussionmentioning

confidence: 97%

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The role of video-assisted thoracoscopic surgery in the treatment of parapneumonic empyema after the failure of fibrinolytics

et al. 2001

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Section: Discussionmentioning

confidence: 97%

“…Many questions remain regarding the definition of the effectiveness of the procedure, the timing of its implementation, and the indications for its use [1,10,16,17,25,27,28].…”

mentioning

confidence: 99%

The role of video-assisted thoracoscopic surgery in the treatment of parapneumonic empyema after the failure of fibrinolytics

et al. 2001

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“…The best results were obtained when the method was applied early in the course of the disease. The number of patients treated is relatively small and only a few authors [44][45][46][47] presented studies with .50 patients.…”

Section: Results and Complicationsmentioning

confidence: 99%

“…Complications are strictly related to case complexity and are mainly represented by air leaks, which are sometimes prolonged, and by bleeding, with incidences of between 16 [42] and 0% [31,39]. In some surgical series comprising patients with heavy comorbidities, some deaths were described [38,40,42,[44][45][46].…”

Section: Results and Complicationsmentioning

confidence: 99%

Advanced techniques in medical thoracoscopy

Tassi¹,

Davies²,

Noppen³

2006

European Respiratory Journal

103

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For expert pulmonologists, advanced procedures in medical thoracoscopy are the nonroutine and more complex applications of the method. The main current indications are the treatment of infected pleural space, forceps lung biopsy and sympathectomy.In parapneumonic effusions and empyema, medical thoracoscopy is as a drainage procedure, intermediate between tube thoracostomy and video-assisted thoracoscopic surgery (VATS), which is efficient, significantly lower in cost and avoids surgical thoracoscopy under general anaesthesia. It is essential that it is performed early in the course of the disease and is particularly advisable for frail patients at high surgical risk.The efficacy of forceps lung biopsy has been demonstrated in diffuse lung diseases, whereas results in localised lung diseases and chest-wall lesions have been less positive. However, VATS is currently the preferred approach for these indications. The technique still maintains its efficacy for visceral pleura and peripheral lung biopsy, in particular in the presence of pleural effusion and lung disorders.At the present time, thoracoscopic sympathectomy is minimally invasive and is an accepted intervention for patients with a variety of autonomous nervous system disturbances. Essential hyperhidrosis patients, and well-selected patients with other disorders, can be helped with this procedure, which can also be performed by interventional pulmonologists.

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“…The advent of video-assisted thoracic surgery (VATS) for the management of fibrinopurulent stage II empyema has shown rewarding results in several reports. [6][7][8][9][10][11][12] VATS has the advantage to be less invasive than open decortication and to have a better acceptance by the patient.…”

Section: Discussionmentioning

confidence: 99%

Paediatric empyema: video-assisted thoracoscopic surgery (vats) and its outcome study

Manasa

Swetha

Yashoda

et al. 2017

Int J Contemp Pediatr

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Background: Empyema thoracis defined as purulent pleural effusion is a common condition in children with significant morbidity and mortality. The aim of therapy for empyema is to ensure rapid recovery with a normal long term pulmonary outcome. VATS (Video-assisted thoracoscopic surgery) is gaining acceptance as a primary modality of treatment in cases of early empyema. VATS is associated with decreased morbidity and reduced hospital stay of the patient. Methods: This is a retrospective observational study conducted in the department of pediatrics KIMS Hospital, Bengaluru from November 2014 to November 2016. In this study, review of the medical records of all the children aged 2 months to 18 years, who underwent VATS for empyema was done. The children included in the study were diagnosed with empyema thoracis based on chest X- ray, USG chest and CT chest and have undergone VATS by pediatric surgical team. Results: The median age of presentation was 4.1 yrs. 18 children were malnourished of which 3 had severe malnutrition. Male to female ratio was 1:1. Most common symptoms were fever (96%), cough (84%), respiratory distress (61%) and chest pain (48%). All patients had parapneumonic effusions and received antibiotics before undergoing surgery. Post-operative supplemental oxygen was required for 2.5±0.5 days. Chest tubes were removed in 4.53±0.7days and duration of stay in hospital was 8.26±1.77 days. All patients were afebrile before discharge and were discharged on oral antibiotics. Follow-up data showed that symptoms resolved in 24 children, 2 children had complications, one child had a pneumothorax and another had a broncho-pleural fistula. Results: Most common symptoms were fever (96%), cough (84%), respiratory distress (61%) and chest pain (48%). All patients had parapneumonic effusions and received antibiotics before undergoing surgery. Post-operative supplemental oxygen was required for 2.5±0.5 days. Chest tubes were removed in 4.53±0.7days and duration of stay in hospital was 8.26±1.77 days. All patients were afebrile before discharge and were discharged on oral antibiotics.Conclusions: These results suggest that primary operative therapy in the form of VATS is an effective treatment option for children with empyema. VATS is associated with a lower in-hospital mortality rate, re-intervention rate, length of stay and duration of tube thoracostomy.

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Video-assisted thoracoscopic treatment of pleural empyema *1A new therapeutic approach

Cited by 27 publications

References 0 publications

The role of video-assisted thoracoscopic surgery in the treatment of parapneumonic empyema after the failure of fibrinolytics

The role of video-assisted thoracoscopic surgery in the treatment of parapneumonic empyema after the failure of fibrinolytics

Advanced techniques in medical thoracoscopy

Paediatric empyema: video-assisted thoracoscopic surgery (vats) and its outcome study

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