Video-assisted thoracoscopic surgery for fibrinopurulent pleural empyema in 67 patients

Détails

ID Serval
serval:BIB_ED9DF9180616
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Video-assisted thoracoscopic surgery for fibrinopurulent pleural empyema in 67 patients
Périodique
Annals of Thoracic Surgery
Auteur(s)
Striffeler  H., Gugger  M., Im Hof  V., Cerny  A., Furrer  M., Ris  H. B.
ISSN
0003-4975 (Print)
Statut éditorial
Publié
Date de publication
02/1998
Volume
65
Numéro
2
Pages
319-323
Notes
Journal Article --- Old url value: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9485221 --- Old month value: Feb
Résumé
BACKGROUND: The roles of different drainage procedures in the management of empyema have to be redefined now that video-assisted thoracoscopic surgery (VATS) has been introduced. The debridement of fibrinopurulent stage II empyema with the use of VATS was assessed prospectively in regard to control of infection and restoration of pulmonary function. METHODS: Between January 1992 and May 1996, all patients at our institution with fibrinopurulent empyema that did not respond to chest tube drainage and antibiotic therapy were treated by debridement with the use of VATS. The patients were followed up prospectively by clinical and radiologic assessments 3 and 6 months after the operation and by spirometry 6 months after the operation. RESULTS: Video-assisted thoracoscopic surgery was initiated in 67 patients, but conversion to open decortication was required because of the finding of advanced disease in 19 patients (28%). Forty-eight patients underwent successful debridement with the use of VATS. The mean operative time was 82.1 minutes (range, 50 to 135 minutes), the mean duration of postoperative chest tube placement was 4.1 days (range, 2 to 8 days), and the mean duration of postoperative hospitalization was 12.3 days (range, 4 to 42 days). No wound infections were observed during the postoperative course. Both the 30-day mortality rate and the recurrence (ie, need for thoracotomy) rate were 4%. The mean predicted vital capacity was 84.8% +/- 14.9% and the mean predicted forced expiratory volume in 1 second was 88.6% +/- 19.2% 6 months after the operation. CONCLUSIONS: Debridement with the use of VATS is safe and efficient for stage II empyema, but open decortication should be used for more advanced disease.
Mots-clé
Adult Aged Aged, 80 and over Child Debridement Empyema, Pleural/metabolism/mortality/*surgery Endoscopy/*methods Fibrin/metabolism Forced Expiratory Volume Humans Infant Middle Aged Pleura/metabolism Prospective Studies Recurrence Survival Rate Thoracic Surgical Procedures/*methods *Thoracoscopy *Video Recording Vital Capacity
Pubmed
Web of science
Création de la notice
29/01/2008 13:59
Dernière modification de la notice
20/08/2019 17:15
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