Abstract
Introduction: Parapneumonic empyema (PPE) is a difficult problem in modern medicine despite availability of antibiotics. Treatment with antibiotics, closed chest tube drainage and intrapleural fibrinolitics are recommended as first line treatment. Video-assisted thoracic surgery is effective in the early stages of PPE. Standard thoracotomy is used in PPE late stage 2b-3. Less invasive approach such as mini-thoracotomy is still has not well received for the late stage of PPE in adult patients.
Aim of the study: To evaluate the results of mini-thoracotomy for treatment of adult PPE in stages 2b-3 versus standard thoracotomy.
Methods: 57 adult patients with PPE in stages 2b-3 operated between 10/ 2001 and 10/ 2013 were selected. Demographic data, clinical manifestations, radiological appearance, histological characteristics of PPE, complications, length of stay in hospital, and early and late postoperative outcome were collected and analyzed.
Results: Of 57 patients 41 (71.9%) were male and 16 (28.1%) – female,
26 patients were in mini-thoracotomy group and 31 patients in standard thoracotomy group.
Physical restoration was quicker in mini-thoracotomy group and complete after one month. There was no difference in normalization of other clinical and laboratory parameters between the two groups.
Conclusions: Treatment of advanced PPE stage 2b-3 with mini-thoracotomy and standard thoracotomy was beneficial for both groups. Employment of mini-thoracotomy had the same efficacy as standard thoracotomy, but was characterized by quicker restoration of physical status due to less invasive approach.
- Copyright ©the authors 2016
