ISMICS 2024 Annual Meeting

Surgical versus non-surgical treatments for parapneumonic effusion or empyema

The Catholic University of Korea, St. Vincent Hospital, Suwon,Republic of Korea

YongJin Chang, MinSeop Cho and DeogGonCho

Objective

•To confirm the superiority of Video-assisted thoracic surgery (VATS) by comparing the effects of surgical and non-surgical treatment for parapneumonic effusion (PPE) or empyema

Methods

•From Apr 2004 to Oct 2020

•St.Vincent’s Hospital

•Retrospectively review

•Acute empyema with PPE

•Pigtail catheter drainage or VATS or both

•Treatment success – recovery of CP angle with full expansion of lung

Patient characteristics

Radiologic and laboratory findings

Stage of Empyema

Outcomes

Discussion

VATS should be the first-line approach in all patients with stage II acute empyema

The main technical considerations include safe access into the chest, drainage of pleural space, and maneuvers to allow full expansion of lung (ie, release of inferior pulmonary ligament) resulting in obliteration of dead space in the hemithorax.

•The VATS procedure facilitates the evacuation of multilocular effusions, the division of a fibrin septum or band, decortication, debridement, irrigation, fluid sampling, and pleural biopsy

•VATS is a safe and effective procedure for treatment of complicated parpneumonic effusion or empyema

•Earlier intervention with VATS to treat complicated parapneumonic effusion or empyema can get better results

Limitation

•Retrospective study

•Selection bias

- In fact, the direction of treatment has been determined

by Respiratory physician.

Conclusion

•VATS is a very effective treatment as management of acute empyema.

•In particular, it is valuable as a first-line treatment for patients with complicated PPE and empyema.

•If practically possible, let's try to intervene more actively.

ISMICS 2024 Annual Meeting

Surgical versus non-surgical treatments For Parapneumonic Effusion

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