title: The Aquamantys(®) system improves haemostasis and pneumostasis in open decortication for thoracic empyema.
abstract: BACKGROUND
  Decortication for thoracic empyema is associated with significant blood loss and prolonged postoperative air leak. We sought to assess the potential application of an irrigated-tip radiofrequency (RF) sealing device, in an attempt to reduce this morbidity.
  
  
  METHODS
  Data for all patients undergoing open decortication (OD) for stage II thoracic empyema, using either conventional approach or facilitated by use of the Aquamantys(®) device, at a single thoracic surgical unit between April 2010 and July 2014, were retrospectively analysed. Unpaired t-test and Fisher's exact test were used for statistical analysis.
  
  
  RESULTS
  Thirty-three patients, aged 54±15 years (mean ± SD), and with a Charlson comorbidity index of 2.5±1.9 were included. Preoperative and intraoperative characteristics, including surgical time, were similar in the conventional and Aquamantys(®) groups. Patients in the Aquamantys group were less likely to require red cell transfusion (9/22 vs. 10/11 patients, P=0.024) and received lower volume transfusions [0.0 (2.0) vs. 3.0 (1.6) units (median, IQR), P<0.0001]; chest drain duration was shorter [3.0 (1.0) vs. 6.5 (6.8) days, P=0.006], as was length of postoperative hospital stay [6.0 (8.7) vs. 10.0 (4.6) days, P=0.031]. There was no demonstrable difference in mortality.
  
  
  CONCLUSIONS
  Our data indicates that the use of irrigated tip RF ablation is safe and effective in improving pneumostasis and haemostasis in decortication for thoracic empyema; and that this translates to morbidity and logistical benefit.
authors: Papworth Hospital, Cambridge, UK ;
authors: Edward J
authors: EJ
authors: Caruana
authors: Norfolk and Norwich University Hospital, Norwich, UK ;
authors: Jakub
authors: J
authors: Kadlec
authors: Papworth Hospital, Cambridge, UK ;
authors: Swetha
authors: S
authors: Iyer
authors: John Radcliffe Hospital, Oxford, UK.
authors: Aleksander
authors: A
authors: Mani
authors: Papworth Hospital, Cambridge, UK ;
authors: Piergiorgio
authors: P
authors: Solli
authors: Papworth Hospital, Cambridge, UK ;
authors: Marco
authors: M
authors: Scarci
keywords: Aquamantys; Decortication; empyema; pneumostasis; radiofrequency (RF)