[Therapy of acute empyema thoracis using thoracoscopic instruments]

Adequate pleural drainage is imperative for the treatment of acute empyema thoracis. But chest tube drainage sometimes cannot operate effectively if blocked by intrathoracic loculations. We successfully treated two cases of acute empyema thoracis using thoracoscopy. These patients had both undergone closed intercostal drainage, but the drains had not worked effectually. We performed thoracoscopy under local anesthesia. Loculations were broken by the thoracoscopic instruments. After pleural irrigation, chest tubes were properly positioned under thoracoscopy. It seems likely that thoracoscopic procedures may be useful in shortening the length of hospitalization and in improving lung re-expansion of acute empyema thoracis patients.