Thoracoscopic debridement and/or decortication for thoracic empyema: a comparative study with open decortication

ABSTRACT

To compare between thoracoscopic debridement and/or decortication versus open decortication in the management of thoracic empyema. This retrospective study was conducted out at King Hussein Medical Center, during the period of December 2006 and November 2011. Fifty-five patients with the diagnoses of stage two or three thoracic empyema were included in this study. The patients were divided in two groups. Group A included patients who underwent thoracoscopic debridement and/or decortication and group B included patients who underwent open decortication. Efficacy of the procedure, operative time, and postoperative blood loss, the need for ventilator support, postoperative complications, postoperative hospital stay and mortality were compared in both groups. Males constituted 61.8% [n=34] of the studied patients. Twenty-nine patients [52.7%]; underwent thoracoscopic debridement and /or decortication while 26 patients [47.3%] underwent open decortication. Mean age [range] was 36.55 +/- 16.47 [16-70] years for group A, and 37.70 +/- 14.28 [17-67] years for group B. There was no statistical significant difference between both groups regarding postoperative hospital stay [P=0.1012] and duration of air leak [P=0.1515]. Duration of the procedure was 209.29 +/- 20.93 minutes for group A patients, while it was 97.86 +/- 38.06 minutes for group B patients [P<0.001]. Three out of the 26 patients [11.5%] who underwent open decortication died in the postoperative period though the fatality was zero in group A patients. Thoracoscopic debridement and/or decortication should be considered as the first surgical option in the management of stage two and three thoracic empyema.