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MMCTS (January 9, 2006). doi:10.1510/mmcts.2004.000273
Copyright © 2006 European Association for Cardio-thoracic Surgery

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Procedure


Video-assisted thoracoscopic surgery and open decortication for pleural empyema

Hans-Beat Ris* and Thorsten Krueger

Department of Thoracic Surgery, CHUV, 1011 Lausanne, Switzerland

* Corresponding author: * Tel.: +41-21-3142 408; fax: +41-21-3142 358. E-mail: hans-beat.ris{at}chuv.hospvd.ch

Video-assisted thoracoscopic treatment is an elegant method for the treatment of ATS stage II fibrinopurulent empyema. It has been shown to be superior to repeat instillation of fibrinolytic agents into the chest cavity. However, a more chronic empyema (organizing empyema, ATS stage III empyema) requires open decortication in order to prevent ongoing infection and late restriction. Conversion thoracotomy should be liberally used if a chronic stage III empyema is found at VATS exploration since open decortication is still the best treatment modality for chronic empyema.

Key Words: American Thoracic Society staging system • Decortication • Pleural empyema • Video-assisted thoracic surgery

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Copyright © 2006 by The European Association for Cardio-thoracic Surgery.