title: Video-assisted thoracic surgery for fibropurulent thoracic empyema: a bridge to open thoracic surgery.
abstract: BACKGROUND
  Thoracic empyema remains a serious problem.
  
  
  OBJECTIVE
  We evaluated the feasibility and efficacy of video-assisted thoracic surgery (VATS) for fibropurulent thoracic empyema.
  
  
  METHODS
  Twenty-six consecutive patients with thoracic empyema resistant to medical therapy were treated by VATS from 1997 to 2006. The presence of pleural adhesion was not a contraindication. Patients with destroyed lung, bronchopleural fistula, or excessively thickened pleura were excluded.
  
  
  RESULTS
  Twenty-two were males and 4 were females with a mean age of 59 years (range 14 to 85). The length of preoperative period was 39.3 +/- 25.3 days, and the length of preoperative treatment was 11.2 +/- 14.3 days. The operating time was 127.6 +/- 45.1 minutes and intraoperative bleeding was 353.8 +/- 438.4 g. Postoperative complications were observed in two cases (8.0%). There were no hospital deaths. Twenty-two cases (84.6%) were cured with a postoperative drainage time of 12.5 +/- 8.2 days. Four cases required an additional operation. However, the VATS procedure was not required to perform additional thoracoplasty using pedicled chest wall muscles.
  
  
  CONCLUSIONS
  VATS for fibropurulent thoracic empyema is effective and less invasive, and it may be important as a bridge between minimally invasive and conventional open thoracic surgical management.
authors.affiliation: Division of General Thoracic Surgery, Respiratory Center and Clinical Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Sadanori
authors.initials: S
authors.lastname: Takeo
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Suemitsu
authors.forename: Hironori
authors.initials: H
authors.lastname: Matsuzawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okazaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016063:Blood Loss, Surgical; D004322:Drainage; D016724:Empyema, Pleural / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D013905:Thoracoplasty; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents