Indication of video-assisted thoracoscopic decortication in treatment of tuberculous empyema / 中国内镜杂志

ABSTRACT

Objective To evaluate the efficacy of decortication by video-assisted thoracic surgery (VATS) in pa﹣tients with tuberculous empyema, and discuss its indications. Methods 60 patients with tuberculous empyema who underwent decortication by VATS for surgical management from December 2010 to December 2015 were included. Under a thoracoscope, we cleaned up the pus, separated adhesions, scraped granulation tissues and caseous necrosis on the inner wall of the abscess cavity, and stripped the thickened fiberboard of the parietal and visceral pleurae. Af﹣ter the procedure, sufficient drainage and antituberculosis therapy were carried out. Results All the patients in this group were operated successfully. All the patients were cured without perioperative death and complications. No re﹣currence of empyema was observed at the follow-up examination from 2 months to 5 years, and suffered pulmonary reexpansions were better. Conclusions The decortication by VATS for tuberculous empyema is safe, effective, mini﹣mally invasive. The imaging manifestations of pleural thickening in 1 cm, no obvious calcification, no serious lesions in the lungs are the indications for the operation.