[Video-assisted thoracoscopic debridement for acute empyema; a low invasive surgery for acute empyema]

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.

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.

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.

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.