Uniportal Video-assisted Thoracic Surgery Decortication For Empyema: A Single Surgeon Experience
Stevan Pupovac1, David Zeltsman2
1Northwell Health at Hofstra School of Medicine, Astoria, NY, USA, 2Northwell Health at Hofstra School of Medicine, Queens, NY, USA
Objective: Recent years reveal a trend towards employing a minimally-invasive approach for the treatment of empyema. Single-incision, or uniportal, VATS surgery has been reported, however, limited data exists regarding the treatment of empyema. Consequently, we retrospectively evaluated intra- and peri-operative outcomes in all patients undergoing single-incision VATS decortication for the treatment of empyema over a five-year period.
Methods: Over a five-year period, 52 consecutive patients underwent uniportal VATS decortication for empyema. Intraoperative data and short-term clinical outcomes were analyzed in all patients.
Results: Nineteen women and thirty-three men underwent uniportal VATS decortication. Median length of stay following decortication was seven days. Mean operative time was 101.76 ± 80.85 minutes. There were no conversions to open surgery or addition of extra VATS incision. Post-operative intensive-care unity (ICU) stay was required in 14 of 52 (27%) patients for a median ICU length of stay of 3 days. Median chest-tubes duration was 4 days. There was no operative mortality. Major perioperative complications were minimal, with zero episodes of reported stroke, reoperation for bleeding, new renal failure, and myocardial infarction and three episodes of sepsis of any cause.
Conclusions: Based on our institution’s experience with the uniportal VATS approach to the treatment of empyema, we feel that it is a safe, effective and feasible approach that could be added to the armamentarium of the thoracic surgeon.
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