Journal ArticleDOI
Surgical treatment of postpneumonic empyema.
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TLDR
VATS débridement for loculated fibrinopurulent postpneumonic empyema offers better results than thoracotomy in terms of resolution of the disease and length of stay in hospital and seems to be more advantageous, resulting in fewer surgical sequelae, lower cost, less labor impediment, and better cosmesis.Abstract:
Postpneumonic empyema complicates 5% of all pneumonia cases. The loculated fibrinopurulent stage cannot be resolved by drainage tube insertion alone; it requires a debriding limited thoracotomy. Recent reports of series seem to indicate that video-assisted thoracic surgery (VATS) can replace thoracotomy advantageously. Eighty-six cases of postpneumonic empyema were operated on in our institution during the last 12 years: 33 cases (group I) using limited thoracotomy (1985–1991) and 53 by VATS (1992–1996). Data were collected prospectively for group II and retrospectively for the first group. The two populations were comparable in age, gender, stage of disease, and co-morbid status. There were no significant differences between the groups. VATS debridement for loculated fibrinopurulent postpneumonic empyema offers better results than thoracotomy in terms of resolution of the disease and length of stay in hospital. It also seems to be more advantageous, resulting in fewer surgical sequelae, lower cost, less labor impediment, and better cosmesis.read more
Citations
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Journal ArticleDOI
BTS guidelines for the management of pleural infection in children
I M Balfour-Lynn,E Abrahamson,G Cohen,J Hartley,S King,D Parikh,David A. Spencer,Anne Thomson,D Urquhart +8 more
TL;DR: Each section of the guideline was researched and drafted by a subgroup of the Paediatric Pleural Diseases Subcommittee (itself a subcommittee of the BTS Standards of Care Committee).
Journal ArticleDOI
Outcomes of Video-Assisted Thoracoscopic Decortication
Betty C. Tong,Jennifer M. Hanna,Eric M. Toloza,Mark W. Onaitis,Thomas A. D'Amico,David H. Harpole,William R. Burfeind +6 more
TL;DR: Thoracoscopic decortication for empyema, complex pleural effusion, and hemothorax yields results that are at least equivalent to open decortation, suggesting that a thoracoscopic approach is an effective and reasonable first option for most patients with complex Pleural effusions andEmpyema.
Journal ArticleDOI
Video-assisted thoracic surgery in the treatment of pleural empyema.
TL;DR: VATS is considered to be the technique of first choice for the treatment of pleural empyema when the disease is advanced or tube thoracostomy fails and it provides excellent results with a low level of invasiveness and considerably reduces the need for thoracotomy.
Journal ArticleDOI
Advanced techniques in medical thoracoscopy
G F Tassi,R J O Davies,M Noppen +2 more
TL;DR: For expert pulmonologists, advanced procedures in medical thoracoscopy are the nonroutine and more complex applications of the method, and thoracoscopic sympathectomy is an accepted intervention for patients with a variety of autonomous nervous system disturbances.
Journal ArticleDOI
Video-assisted thoracoscopic surgery for thoracic empyema: primarily, or after fibrinolytic therapy failure?
Ioannis E. Petrakis,Nektarios Kogerakis,Ioannis Drositis,K.G. Lasithiotakis,Demosthenes Bouros,Georgios Chalkiadakis +5 more
TL;DR: VATS should be considered as the treatment of choice for thoracic empyema, in the fibrinopurulent stage, as it is more effective when applied primarily than when applied after fibrinolytic therapy.
References
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Journal ArticleDOI
A Randomized Trial of Empyema Therapy
TL;DR: In patients with loculated, complex fibrinopurulent parapneumonic empyema thoracis, a primary treatment strategy of VATS is associated with a higher efficacy, shorter hospital duration, and less cost than a treatment strategy that utilizes catheter-directed fibrinolytic therapy.
Journal ArticleDOI
VATS debridement versus thoracotomy in the treatment of loculated postpneumonia empyema
Tomás A. Angelillo Mackinlay,Gustavo Lyons,Domingo Chimondeguy,Miguel Barboza Piedras,Gustavo Angaramo,Juan Emery +5 more
TL;DR: It is concluded that video-assisted thoracic surgical treatment has the same rate of success as open thoracectomy but offers substantial advantages over thoracotomy in terms of resolution of the disease, hospital stay, and cosmesis.
Journal ArticleDOI
Thoracoscopic debridement and pleural irrigation in the management of empyema thoracis
P.D. Ridley,Mark V. Braimbridge +1 more
TL;DR: Thoracoscopic debridement and irrigation used routinely as a first-line measure in empyema thoracis is a safe and relatively atraumatic procedure, does not exclude the use of any subsequent surgical measure, and provides valuable time to improve the condition of debilitated patients so that they may tolerate more aggressive surgical procedures.
Journal ArticleDOI
Early Aggressive Surgical Management of Parapneumonic Empyemas
TL;DR: In those patients who do not respond well to a short course of chest tube drainage, it is found that an age greater than 60 years, cardiac disease, end-stage renal disease, End-stage bronchitis, prolonged tube drainage and immunosuppression are associated with increased morbidity and mortality.