Video-Assisted Thoracoscopic Surgery for the Stage II Pleural Empyema: A Prospective Observational Study

Area of Science:

• Thoracic Surgery
• Minimally Invasive Procedures
• Pulmonary Medicine

Background:

• Empyema thoracis, characterized by purulent pleural fluid, remains a significant clinical challenge.
• Common causes include pneumonia complications, abdominal infections, trauma, and post-surgical sequelae.
• Despite advancements, effective management of pleural empyema is crucial.

Purpose of the Study:

• To evaluate the efficacy of Video-Assisted Thoracoscopic Surgery (VATS) for Stage II empyema thoracis.
• To assess VATS's impact on hospital stay duration, drain removal, and recovery.
• To analyze complications associated with VATS in empyema treatment.

Main Methods:

• Prospective observational study of 31 patients with Stage II empyema diagnosed via HRCT.
• All patients underwent thoracoscopic decortication.
• Pleural tissue and fluid analyzed biochemically, microbiologically, and histopathologically.

Main Results:

• The majority of patients (93.5%) experienced uneventful recovery.
• VATS led to a reduced hospital stay, with most patients discharged within a week.
• Complications included pulmonary embolism (3.2%) and conversion to thoracotomy (3.2%).

Conclusions:

• Empyema thoracis should be suspected in unresponsive pneumonia cases.
• Ultrasound and HRCT are vital for diagnosis; chest radiography aids postoperative monitoring.
• Early VATS referral can prevent disease progression, reducing morbidity and mortality.