[Evaluation of uniportal video-assisted thoracoscopic decortication in treatment of drug-resistant tuberculous empyema].

To examine the safety and efficacy of the uniportal video-assisted thoracoscopic decortication in treatment of drug-resistant tuberculosis empyema. From January 2018 to December 2020, 122 cases of tuberculous empyema treated by decortication in Department of Surgery, Wuhan Pulmonary Hospital were retrospectively analyzed, including 100 males and 22 females, aged((IQR)) 29.5(28.0) years (range: 13 to 70 years). According to the surgical approach and drug resistance, patients with drug-resistant tuberculosis who underwent uniportal video-assisted thoracoscopic decortication were included in group A (=22), and those who underwent thoracotomy decortication were included in group B (=28). Drug-sensitive patients who underwent uniportal video-assisted thoracoscopic decortication were included in group C (=72). There was no statistical difference in the baseline data of the three groups (>0.05). The operation, early postoperative recovery, and prognosis-related indicators were compared among three groups by Kruskal-Wallis test and test by Mann-Whitney test and Bonferroni method between groups A and B, groups A and C. The intraoperative blood loss of group A, group B, and group C was 200(475) ml, 300(200) ml, and 225(300) ml, respectively. There was no significant difference in intraoperative hemorrhage (=2.74, =0.254) and treatment outcome (=4.76, =0.575) among the three groups. Compared with group B, the operation time of group A (302.5(187.5) minutes 200.0(60.0) minutes, =171.0, =0.007) and postoperative pulmonary reexpansion duration (4.5(3.0) months 3.0 (2.2) months, =146.5, =0.032) were longer, and the postoperative drainage duration (9.5(7.8) days 13.0(10.0) days, =410.0, =0.044), and the postoperative hospitalization time (12.0(7.8) days 14.5(4.8) days, =462.2, =0.020) were shorter. There was no significant difference in complications between group A and group B (63.6%(14/22) 71.4%(20/28), =0.34, =0.558). Compared with group C, the postoperative drainage duration of group A (9.5(7.8) days 7.0(4.0) days, =543.5, =0.031), the postoperative hospitalization time (12.0(7.8) days 9.0(4.0) days, =533.0, =0.031) and postoperative pulmonary reexpansion duration (4.5(3.0) months 3.0(2.0) months, =961.5, =0.001) were longer. The operation time (302.5(187.5) minutes 242.5(188.8) minutes, =670.5, =0.278), and complications (63.6%(14/22) 40.3%(29/72), =3.70, =0.054) were not different between group A and group C. For drug-resistant tuberculous empyema, the uniportal video-assisted thoracoscopic decortication can achieve the same good therapeutic effect as drug-sensitive tuberculous empyema, and it is as safe as thoracotomy. At the same time, it has the advantage of minimally invasive and can accelerate the early postoperative recovery of patients.