Surgical management for pleural empyema – Single-center experience

Abstract

Background: Pleural empyema occurs due to primary lung parenchymal infection or due to other pathologies. In this study, we analyzed the surgical management of empyema at our center. Patients and Methods: This study is a retrospective analysis of the patients who were surgically managed for pleural empyema between September 2014 and September 2017. A total of 54 patients underwent surgical management in the form of video-assisted thoracoscopic surgery (VATS) decortication or open procedure or a combination of both. The study population was evaluated for comorbid conditions, association with tuberculosis, bacteriological culture, length of hospital stay, morbidity and mortality. Results: Primary empyema was present in 52 patients while two patients had secondary empyema. Mycobacterium tuberculosis was associated in 17 (32%) patients, while 25 patients had other bacterial organisms. VATS decortication was performed in 21 (39%) patients and 23 (43%) patients underwent the open procedure. The remaining 10 patients underwent the combined procedure. The operative time and mean duration of hospital stay were less in the VATS group compared to the open group. Conclusion: In our experience, early surgical management of Stage II and Stage III empyema is successful with VATS. The nature of the disease process and the learning curve for VATS plays an important role in the conversion to open procedure.

Keywords

• Open decortication
• pleural empyema
• video-assisted thoracoscopic surgery decortication