title: Video-assisted evacuation of empyema is the preferred procedure for management of pleural space infections.
abstract: BACKGROUND
  Empyema remains a cause of morbidity and mortality. Thoracoscopy has proved its versatility in the management of pleural space disorders. The suitability of video-assisted thoracic surgery (VATS) for decortication in the management of the fibrotic stage of empyema is unclear.
  
  
  METHODS
  VATS evacuation of empyema and decortication was performed on seventeen patients presenting with pleural space infections. A retrospective review was performed and constitutes the basis of this report.
  
  
  RESULTS
  VATS evacuation of empyema and decortication was successfully performed in 13 of 17 patients. Blood loss was 325 +/- 331 cc. Mean hospital stay was 18 +/- 10 days. Postoperative hospitalization was 11 +/- 7 days. Chest tubes remained in place for 7 +/- 3 days. There were no operative mortalities.
  
  
  CONCLUSIONS
  Video-assisted evacuation of empyema and decortication is an effective modality in the management of the exudative and fibrinopurulent stages of empyema. An organized empyema should be approached thoracoscopically, but may require open decortication.
authors.affiliation: Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, New York 11040, USA.
authors.forename: R P
authors.initials: RP
authors.lastname: Lackner
authors.forename: R
authors.initials: R
authors.lastname: Hughes
authors.forename: L A
authors.initials: LA
authors.lastname: Anderson
authors.forename: P H
authors.initials: PH
authors.lastname: Sammut
authors.forename: A B
authors.initials: AB
authors.lastname: Thompson
mesh_terms: D016063:Blood Loss, Surgical; D015505:Chest Tubes; D016724:Empyema, Pleural / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed