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Definitive Management of Advanced Empyema by Two-Window Video-Assisted Surgery

Department of Surgery
¹ Clinical Audit and Effectiveness Unit, Papworth Hospital, Cambridge, United Kingdom

For reprint information contact: Andrew J Drain, MRCS Tel: 44 1480 830 541 Fax: 44 1480 364 335 Email: andrewdrain{at}doctors.org.uk, Department of Surgery, Papworth Hospital, Papworth Everard, Cambridge, CB3 8RE, United Kingdom.

We describe how 2-window video-assisted thoracoscopic decortication and lung mobilization can provide definitive management of stage III empyema. This technique was used in 52 patients with stage III empyema. None required additional ports or a thoracotomy. Three patients (6%) needed computed tomography-guided drainage of persistent large loculi, but none required further surgery. Chest radiographs at 6 weeks after surgery confirmed full lung expansion and resolution of pleural collection in the other 49 patients (94%).