[Video-assisted thoracoscopic debridement for acute empyema; a low invasive surgery for acute empyema].
BACKGROUND: Recent study reported that thoracoscopic surgery for acute empyema can achieve good results. We performed video-assisted thoracoscopic debridement (VD) in cases diagnosed as having acute empyema when conservative therapies such as administration of antibiotics or continuous thoracic drainage were not successful. METHODS: Two to 4 access ports were inserted into the empyema lumen, and surgery were conducted only under monitoring vision. After removing as much pus, coating, fibrin walls and peel as possible, a chest tube was set in the lumen for drainage. Thirty cases treated in our hospital were reviewed with respect to selected parameters. RESULTS: The interval from onset to surgical treatment was 41.0 +/- 21.0 days. All cases were considered in either fibrinopurulent phase or early organizing phase. Pathogenic bacteria were identified in 8 cases. Surgical duration was 93.1 +/- 26.6 minutes. Hospitalization period was 26.3 +/- 36.4 days. Twenty-seven cases showed improvement after the first VD procedure, while 3 cases required repeat procedures. CONCLUSIONS: VD may achieve good results not only in the fiburinopulurent phase but also in the early organization phase. VD is both low invasive and highly effective for acute empyema.