Limits...
Thoracoscopic management of empyema thoracis.

Wait MA, Beckles DL, Paul M, Hotze M, Dimaio MJ - J Minim Access Surg (2007)

Bottom Line: Appropriate management of empyema thoracis is dependent upon a secure diagnosis of the etiology of empyema and the phase of development.Minimal access surgery using video-assisted thoracoscopy (VATS) is one of many useful techniques in treating empyema.Complex empyema requires adjunctive treatment in addition to VATS.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular and Thoracic Surgery, University of Texas, Southwestern Medical Center, Dallas, Texas, USA.

ABSTRACT
Appropriate management of empyema thoracis is dependent upon a secure diagnosis of the etiology of empyema and the phase of development. Minimal access surgery using video-assisted thoracoscopy (VATS) is one of many useful techniques in treating empyema. Complex empyema requires adjunctive treatment in addition to VATS.

No MeSH data available.


Related in: MedlinePlus

CT scan of the same patient in Figure 1, demonstrating loculation and septation of the pleural space, indicating a phase II empyema
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2749197&req=5

Figure 0002: CT scan of the same patient in Figure 1, demonstrating loculation and septation of the pleural space, indicating a phase II empyema

Mentions: Antibiotic therapy is initiated and a thoracentesis is performed to guide therapy (bacterial vs mycobacterial/fungal). A simple uncomplicated effusion/empyema can be managed with multiple thoracentesis and/or thoracostomy tube drainage with antibiotics. Daily and postprocedural X-rays are highly encouraged to detect early failures and progression of disease from simple to complicated empyema. A loculated process is suggested if after drainage there is retained fluid or air/fluid levels seen on postprocedural films and non-layering fluid on decubitus films. Ultrasound examination of the involved hemithorax has been used as an adjunct to diagnose the character of the empyema (presence or absence of septations, diaphragm immobilization, etc.), guide thoracentesis and for repeat assessment if clinical deterioration is evident. CT scans are indicated to more completely assess the anatomy of the infected pleural space, determine the presence of single vs multiple loculations, determine the presence or absence of a lung abscess and bronchopleural fistula and to determine adequacy of pleural drainage [Figure 2].


Thoracoscopic management of empyema thoracis.

Wait MA, Beckles DL, Paul M, Hotze M, Dimaio MJ - J Minim Access Surg (2007)

CT scan of the same patient in Figure 1, demonstrating loculation and septation of the pleural space, indicating a phase II empyema
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2749197&req=5

Figure 0002: CT scan of the same patient in Figure 1, demonstrating loculation and septation of the pleural space, indicating a phase II empyema
Mentions: Antibiotic therapy is initiated and a thoracentesis is performed to guide therapy (bacterial vs mycobacterial/fungal). A simple uncomplicated effusion/empyema can be managed with multiple thoracentesis and/or thoracostomy tube drainage with antibiotics. Daily and postprocedural X-rays are highly encouraged to detect early failures and progression of disease from simple to complicated empyema. A loculated process is suggested if after drainage there is retained fluid or air/fluid levels seen on postprocedural films and non-layering fluid on decubitus films. Ultrasound examination of the involved hemithorax has been used as an adjunct to diagnose the character of the empyema (presence or absence of septations, diaphragm immobilization, etc.), guide thoracentesis and for repeat assessment if clinical deterioration is evident. CT scans are indicated to more completely assess the anatomy of the infected pleural space, determine the presence of single vs multiple loculations, determine the presence or absence of a lung abscess and bronchopleural fistula and to determine adequacy of pleural drainage [Figure 2].

Bottom Line: Appropriate management of empyema thoracis is dependent upon a secure diagnosis of the etiology of empyema and the phase of development.Minimal access surgery using video-assisted thoracoscopy (VATS) is one of many useful techniques in treating empyema.Complex empyema requires adjunctive treatment in addition to VATS.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular and Thoracic Surgery, University of Texas, Southwestern Medical Center, Dallas, Texas, USA.

ABSTRACT
Appropriate management of empyema thoracis is dependent upon a secure diagnosis of the etiology of empyema and the phase of development. Minimal access surgery using video-assisted thoracoscopy (VATS) is one of many useful techniques in treating empyema. Complex empyema requires adjunctive treatment in addition to VATS.

No MeSH data available.


Related in: MedlinePlus