title: Minimally Invasive Vacuum-Assisted Closure Therapy With Instillation (Mini-VAC-Instill) for Pleural Empyema.
abstract: Enthusiasm for minimally invasive thoracic surgery is increasing. Thoracoscopy plays a significant therapeutic role in the fibrinopurulent stage (stage II) of empyema, in which loculated fluid cannot often be adequately drained by chest tube alone. For some debilitated and septic patients, further procedures such as open-window thoracostomy (OWT) with daily wound care or vacuum-assisted closure (VAC) therapy are necessary. In the present article, we propose a new option of minimally invasive VAC therapy including a topical solution of the empyema without open-window thoracostomy (Mini-VAC-instill). Three patients who underwent surgery using this technique are also presented. The discussion is focused on the advantages and disadvantages of the approach.
authors: Hospital Barmherzige Brüder Regensburg, Regensburg, Germany University Regensburg, Regensburg, Germany hans-stefan.hofmann@barmherzige-regensburg.de.
authors: Hans-Stefan
authors: HS
authors: Hofmann
authors: University Regensburg, Regensburg, Germany.
authors: Reiner
authors: R
authors: Neu
authors: University Regensburg, Regensburg, Germany.
authors: Tobias
authors: T
authors: Potzger
authors: Hospital Barmherzige Brüder Regensburg, Regensburg, Germany.
authors: Rudolf
authors: R
authors: Schemm
authors: Hospital Barmherzige Brüder Regensburg, Regensburg, Germany.
authors: Christian
authors: C
authors: Grosser
authors: Hospital Barmherzige Brüder Regensburg, Regensburg, Germany.
authors: Tamas
authors: T
authors: Szöke
authors: Hospital Barmherzige Brüder Regensburg, Regensburg, Germany.
authors: Zsolt
authors: Z
authors: Sziklavari
mesh_terms: D000369:Aged, 80 and over; D016724:Empyema, Pleural / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D013906:Thoracoscopy; D013907:Thoracostomy
keywords: VAC-instill; minimally invasive thoracic surgery; pleural empyema