Background: Empyema is one of the most common and important thoracic diseases which can lead to some sort of debilitating consequences if does not managed properly. Surgery usually is indicated in the third stage of the disease which contains more and devastating complications that do not respond to the other treatment options. This investigation evaluates the role of thoracoscopy (minimal invasive surgical intervention) in the management of second stage of empyema.
Methods: In a prospective investigation, 54 patients with stage II of empyema were selected and divided in two groups. In control group, patients were treated with chest tube thoracic drainage plus antibiotics administration, on the other side, Thoracoscopic diagnosis and drainage was added to the modalities of the control group. Thoracoscopy is aimed to explore the total thoracic cavity for releasing the fibrous bands and adhesions and draining of the loculated abscess. At the end of procedure plural cavity wash out and chest tube insertion were done.
Results: The rate of complication was 35% and 8% (p<0.05) in control group and investigated group, respectively. The average admission days were significantly greater in control group (the investigated group got better faster) (p<0.05). The need for thoracotomy was 7 time greater in control group (p<0.05).
Conclusion: Application of Thoracoscopy for stage 2 of empyema is a safe modality which can be advised for all of the patients. This minimally invasive technique can decrease complications rate, need for thoracotomy and hospital admission time.