Pleural Adhesiolysis and Drainage using Video-Assisted Thoracoscopy in Empyema

Abstract

A thoracic empyema is a collection of pus in the pleural space. The most effective treatment of empyema thoracis remains debated. Among the contending therapies, a technique of irrigation for the management of empyema has been described. Initial thoracoscopy under general anesthesia enabled full debridement and division of loculi within the empyema cavity with direct vision. So we employed thoracoscopic debridement and irrigation in a select group of patients with empyema, excluding those with complications, severely debilitated patients, and those with bronchopleural fistula. In particular we chose patients in the second phase of fibropuruient empyema for inclusion. All cases except one with lung cancer were completely resolved. Our results indicate that thoracoscopic debridement and drainage as a first-line measure for second phase empyema thoracis is a safe and relatively atraumatic procedure.