Video-Assisted Thoracoscopic Surgery versus Open Decortication in Chronic Pleural Empyema

Ahmed  Labib Dokhan; Islam Moheb Ibrahim; Sarah Mohammed Abdel Sadek; Mohammed  Gamal El-din Hagag

doi:10.35810/ects.v4i4.222

Ahmed Labib Dokhan Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Islam Moheb Ibrahim Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Sarah Mohammed Abdel Sadek Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Mohammed Gamal El-din Hagag Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

DOI: https://doi.org/10.35810/ects.v4i4.222

Keywords: Empyema, Video-assisted thoracoscopic surgery (VATS), Open decortication, Pain scale

Abstract

Background: The role of video-assisted thoracoscopic surgery (VATS) for managing organized empyema is still limited. This study compared VATS versus open decortication in patients with chronic pleural empyema.

Methods: This randomized controlled trial included 58 patients with stage III empyema. Patients were divided into two groups. Group A (n= 30) included patients who had decortication through an open thoracotomy, and Group B (n= 28) included VATS decortication patients. Two patients in the VATS group were converted to the open approach and were excluded from the analysis.

Results: The mean age in Group A was 48.23 ± 8.44 years and 49.79 ± 7.85 years Group B (p= 0.47). There were 16 males (53.3%) in Group A and 15 (63.6%) in Group B (p= 0.99). The operative time was 336.0 ± 67.60 min in Group A and 291.07 ± 56.66 min in Group B (p= 0.01). There was no difference in intraoperative complications between groups. Postoperative hospital stay (p= 0.23) and ICU admission (p= 0.24) did not differ between groups. In Group A, the pain scale was 8 (6- 8), and it was 4 (2- 4) in Group B (p˂ 0.001). No difference was recorded in the postoperative complications between groups.

Conclusion: The outcomes of VATS in managing stage III empyema are comparable to the open approach. VATS has the advantage of lower postoperative pain. VATS could be an alternative to open decortication in patients with stage III pleural empyema.

Author Biographies

Ahmed Labib Dokhan , Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Islam Moheb Ibrahim , Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Mohammed Gamal El-din Hagag, Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt