ISMICS - Initial Treatment For Parapneumonic Effusion

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Initial Treatment For Parapneumonic Effusion
YongJin Chang;
The Catholic University of Korea, ST. Vincent�s Hospital, Suwon, Korea, Republic of

BACKGROUND: We intend to confirm the superiority of Video-assisted thoracic surgery (VATS) by comparing the effects of surgical and non-surgical treatment for parapneumonic effusion (PPE) or empyema through this study.
METHODS: From Apr 2004 to Oct 2020, we retrospectively reviewed the medical records of patients with PPE or empyema. Patients who received thoracostomy with pigtail catheter or VATS were enrolled into this study. Various parameters including demographical characteristics, change of laboratory data, change of plain x-ray, period of pigtail catheter or chest tube drainage, and length of hospital stay were collected and analyzed.
RESULTS: A total of 290 patients were enrolled into the study. 126 patients (Group I) were treated with pigtail catheter, 93 patients (Group II) were treated VATS after treatment with pigtail catheter, whereas 71 patients (Group III) were treated with VATS only. The length of hospital stay was 12.2�6.1, 15.7�8.1, and 14.3�6.2days in each group, respectively (p=0.006). The total drainage period was the shortest in Group I (6.0�4.2, 10.8�6.7, and 6.7�3.8days in each group, respectively. p<0.001). CRP also showed the largest decrease in Group I (14.8�9.8, 10.3�7.8, 9.6�7.9 in each group, respectively. P<0.001). There were three final treatment failures in group III alone.
CONCLUSIONS: VATS is a very effective and excellent treatment method as a first-line management for patients with PPE or empyema.

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