Samancilar Ozgur, Akçam Tevfik İlker, Kaya Seyda Ors, Ozturk Ozgur, Akcay Onur, Ceylan Kenan Can
Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
Department of Thoracic Surgery, Ege University Faculty of Medicine, Izmir, Turkey.
Ann Thorac Cardiovasc Surg. 2018 Feb 20;24(1):19-24. doi: 10.5761/atcs.oa.17-00153. Epub 2018 Jan 17.
Development of multiloculation-septation is a challenging entity in empyema patients. In this study, it is aimed to investigate the success rates of videothoracoscopic deloculation (VATS-D) and intrapleural fibrinolytic (IPFib) application after tube thoracostomy.
The study retrospectively examined the patients diagnosed with empyema with multiloculation and septation between January 2005 and December 2014. Among these patients, the study included those who received VATS-D or IPFib therapy.
VATS-D (Group 1) was applied to 54 patients and IPFib (Group 2) was applied to 24 patients. The success of both procedures was evaluated considering the need of decortication in the following periods. In the VATS-D group, 4 (7.4%) patients required decortication via thoracotomy where it was 1 (4.1%) patient (p = 0.577) in the IPFib group. The length of hospital stay was 6.81 ± 2.55 (4-15) days in Group 1 compared to 14.25 ± 6.44 (7-27) days in Group 2 (p <0.001).
It was demonstrated that both of the methods applied in the study have high efficacy and are preferable methods based on the general conditions of patients. Additionally, the shorter length of hospital stays in patients received VATS-D was established as a significant parameter.
多房分隔的形成在脓胸患者中是一个具有挑战性的问题。本研究旨在探讨胸腔镜下分隔松解术（VATS-D）和胸腔内应用纤维蛋白溶解剂（IPFib）在胸腔闭式引流术后的成功率。
本研究回顾性分析了2005年1月至2014年12月期间诊断为多房分隔性脓胸的患者。在这些患者中，研究纳入了接受VATS-D或IPFib治疗的患者。
54例患者接受了VATS-D（第1组），24例患者接受了IPFib（第2组）。两种手术的成功率均根据后续是否需要行胸膜剥脱术来评估。在VATS-D组，4例（7.4%）患者需要通过开胸行胸膜剥脱术，而在IPFib组为1例（4.1%）患者（p = 0.577）。第1组的住院时间为6.81±2.55（4 - 15）天，而第2组为14.25±6.44（7 - 27）天（p <0.001）。
研究表明，本研究中应用的两种方法均具有较高的疗效，并且根据患者的一般情况是较好的方法。此外，接受VATS-D治疗的患者住院时间较短被确定为一个重要参数。
