VIDEO-ASSISTED THORACOSCOPIC SURGERY FOR PLEURAL DECORTICATION IN EMPYEMA

Résumé fourni par la source

Although video-thoracoscopy occupies a primordial place in a multitude of pleuro-pulmonary and mediastinal surgeries, its adoption in pleuro-pulmonary decortication remains hesitant up to date. We report our experience in the treatment of pleural effusion requiring decortication by video-thoracoscopy. Patients and methods: This is a retrospective study including patients operated for pleural empyema and have had uniportal video-thoracoscopy in our institution between 2021 and 2023. Results: We collected 16 cases (15 men/1 woman). The mean age of the patients was 38 years [16-82]. The most common symptoms were chest pain (n=5), dyspnea (n=8) and fever (n=4). Radiological findings showed enclosed pleural effusion in 11 cases and multiloculated pleural effusion in one case. Nine cases had pleural thickening and six had associated atelectasis. Eleven patients received antibiotics before surgery. The surgical approach was uniportal video-thoracoscopy in all cases. intraoperative bleeding occurred in 6 cases (200-1000mL). The average duration of the surgical procedure was 71 minutes. The average duration of the chest drainage was 7 days. Fifteen patients had uneventful postoperative course. One patient required mechanical ventilation postoperatively and one patient presented a recurrence requiring a second surgery. Conclusion: Video-thoracoscopy is a safe and effective approach in the treatment of pleural empyema requiring decortication. Beyond its minimal damage, it has the advantage of preserving post-operative respiratory function.

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