Lackner R P, Hughes R, Anderson L A, Sammut P H, Thompson A B
Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, New York 11040, USA.
Am J Surg. 2000 Jan;179(1):27-30. doi: 10.1016/s0002-9610(99)00257-3.
Empyema remains a cause of morbidity and mortality. Thoracoscopy has proved its versatility in the management of pleural space disorders. The suitability of video-assisted thoracic surgery (VATS) for decortication in the management of the fibrotic stage of empyema is unclear.
VATS evacuation of empyema and decortication was performed on seventeen patients presenting with pleural space infections. A retrospective review was performed and constitutes the basis of this report.
VATS evacuation of empyema and decortication was successfully performed in 13 of 17 patients. Blood loss was 325 +/- 331 cc. Mean hospital stay was 18 +/- 10 days. Postoperative hospitalization was 11 +/- 7 days. Chest tubes remained in place for 7 +/- 3 days. There were no operative mortalities.
Video-assisted evacuation of empyema and decortication is an effective modality in the management of the exudative and fibrinopurulent stages of empyema. An organized empyema should be approached thoracoscopically, but may require open decortication.
脓胸仍然是发病和死亡的一个原因。胸腔镜已证明其在处理胸膜腔疾病方面的多功能性。电视辅助胸腔手术（VATS）在脓胸纤维化阶段行纤维板剥脱术中的适用性尚不清楚。
对17例出现胸膜腔感染的患者进行了VATS脓胸清除及纤维板剥脱术。进行了回顾性分析，并构成了本报告的基础。
17例患者中有13例成功进行了VATS脓胸清除及纤维板剥脱术。失血量为325±331毫升。平均住院时间为18±10天。术后住院时间为11±7天。胸管留置时间为7±3天。无手术死亡病例。
电视辅助脓胸清除及纤维板剥脱术是治疗脓胸渗出期和纤维脓性期的有效方式。对于有组织的脓胸应采用胸腔镜治疗，但可能需要行开放性纤维板剥脱术。
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