Radiographic Lung Volume Recovery and Clinical Outcomes of Video-Assisted Thoracoscopic Surgery for Early-Stage...

This study aimed to evaluate the clinical and radiographic outcomes of video-assisted thoracoscopic surgery (VATS) for early-stage empyema, emphasizing the restoration of lung volume as a crucial indicator of treatment success.

A retrospective analysis was conducted on patients with early-stage empyema who underwent VATS between January 2020 and June 2025. Data regarding inflammatory markers, coagulation parameters, and clinical recovery were systematically collected. A key radiographic outcome, specifically the affected lung volume, was quantitatively assessed using computed tomography (CT) volumetry both preoperatively and postoperatively to objectively evaluate lung re-expansion.

Thirty patients were included in the study. VATS resulted in significant reductions in postoperative inflammatory markers, including white blood cell, neutrophil percentage, C-reactive protein, interleukin-6, and D-dimer (p < 0.05). CT-based lung volume increased significantly from 1,278.81 cm³ (interquartile range [IQR]: 1,021.9-1,677.56) preoperatively to 1,587.81 cm³ (IQR: 1,320.51-1,978.91) at 3 months postoperatively, representing a median absolute increase of 309.0 cm³ (+24.2%, p = 0.002). The mean duration of chest tube drainage was 7.47 ± 3.96 days, and the mean length of hospital stay was 19.70 ± 8.35 days. The 30-day readmission rate was 23.33%.

VATS is a highly effective intervention for early-stage empyema, resulting in significant resolution of systemic inflammation and, importantly, a substantial increase in lung volume. The restoration of lung volume substantiates the procedural efficacy of VATS in facilitating mechanical lung liberation and promoting functional recovery, thereby highlighting its essential role in the management of this condition.