Abstract
Background: Pleural empyema is considered acommon and a severe disease, with high mortality (15%). Pleural empyema can be divided in 3 stages. In stage II and III empyema should be treated with an invasive technique.
Objectives: The aim of this study is to prove the efficacy and safety of medical thoracoscopy, in complicated empyema. Furthermore, to prove that severe patients, could be safely treated with this technique.
Methods: 126 patients with empyema were retrospective studied from March 2005 to March 2019 at our department. Patients were divided into three ultrasound stages of empyema: 10 patients (7,9%) were in stage I, 57 patients (45,2%) were in stage II and 59 patients (46,8%) were in stage III. All the patients in this study were managed with medical toracoscopy.
Results: We found a success rate in 106 patients (84%) of 126: 10 I Stage patients, 54 of 57 II Stage patients (94,7%), 42 of 59 III Stage patients (71, 2%). Thoracic surgery was performed in 3 patients in II Stage group and in 8 patients in III Stage group.
Table 1. Clinical characteristics at Baseline (126) | |
Age – yr(mean) | 64 |
Male –no.(%) | 95 – 75.4% |
Charlson comorbidity index –no.(%) < 5 >=5 | 60 – 46.7% 67 – 53.2% |
History of smoking –no.(%) Never Former Current | 48 – 38.1% 24 – 19% 54 – 42.9% |
Conclusions: This study underline how medical thoracoscopy should be considered the first line of management in Stage II empyema, but it is also a safe tool for Stage III patients with high risk in attending surgery. Organizing empyema needs an interdisciplinary management, due to the fact that it might not respond to medical thoracoscopy, and it requires video-assisted thoracic surgery or open surgical decortications.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3788.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021