title: The role of thoracoscopic debridement in the treatment of parapneumonic empyema.
abstract: OBJECTIVE
  To evaluate the efficacy of early video-assisted thoracoscopic debridement in patients with the fibropurulent phase of parapneumonic empyema.
  
  
  METHODS
  40 patients with parapneumonic empyema resistant to 2 weeks of antibiotic therapy, were randomly divided into 2 groups. In group 1 (20 patients), antibiotic therapy and irrigation was continued, and in group 2 (20 patients), video-assisted thoracoscopic debridement was performed. The 2 groups were compared in terms of therapeutic results.
  
  
  RESULTS
  The male/female ratio was 29/11. Group 1 included 16 men and 4 women with a mean age of 54 years, and mean hospital stay was 41 days. Group 2 consisted of 14 men and 6 women with a mean age of 51 years, and mean hospital stay was 23 days. Considering the therapeutic results, 12 patients in group 1 were cured by antibiotic therapy and irrigation, whereas 8 required decortication and pleurectomy with thoracotomy. In group 2, 18 patients were cured by video-assisted thoracoscopic debridement, and 2 underwent thoracotomy and decortication due to intraoperative bleeding. A significant difference in therapeutic results was noted between the groups (p = 0.028).
  
  
  CONCLUSIONS
  Video-assisted thoracoscopic debridement provides a high success rate and less invasive treatment for the early stages of empyema.
authors.affiliation: Cardiothoracic Surgery & Transplant Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Bagheri
authors.forename: Alireza
authors.initials: A
authors.lastname: Tavassoli
authors.forename: Seyed Ziaollah
authors.initials: SZ
authors.lastname: Haghi
authors.forename: Davoud
authors.initials: D
authors.lastname: Attaran
authors.forename: Ali
authors.initials: A
authors.lastname: Sadrizadeh
authors.forename: Amir
authors.initials: A
authors.lastname: Asnaashari
authors.forename: Reza
authors.initials: R
authors.lastname: Basiri
authors.forename: Maryam
authors.initials: M
authors.lastname: Salehi
authors.forename: Kamran Adhami
authors.initials: KA
authors.lastname: Moghadam
authors.forename: Azadeh
authors.initials: A
authors.lastname: Tabari
authors.forename: Shima
authors.initials: S
authors.lastname: Sheibani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016063:Blood Loss, Surgical; D003646:Debridement / Q000009:adverse effects / Q000379:methods*; D024881:Drug Resistance, Bacterial; D016724:Empyema, Pleural / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007492:Iran; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D007507:Therapeutic Irrigation; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Anti-bacterial agents; blood loss; drainage; empyema; pleural; surgical; thoracic surgery; video-assisted