BACKGROUND: We evaluated a technique of video-assisted thoracoscopic (VAT) decortication of the visceral cortex to reexpand entrapped lung in cases of chronic postpneumonic @entity4327 . METHODS: A prospective cohort study of 48 consecutive @entity1 with multiloculated postpneumonic @entity4327 in whom visceral pleural decortication was required was studied. The effect of VAT decortication on perioperative outcome and factors affecting its success were assessed. RESULTS: Before the introduction of VAT decortication 12 @entity1 were treated by thoracotomy (group T). In the subsequent 36 @entity1 VAT decortication was attempted with success in 21 (group VS) but lung expansion was not observed in 15 @entity1 (group VF) who required thoracotomy. There was no difference in the age or sex distribution of the 3 groups. Operating time was significantly longer in group T than group VS, mean difference 30.3 minutes (p = 0.001) and postoperative hospital stay was longer in group T than group VS, mean difference 2.9 days (p = 0.004). The success of VAT decortication was not related to either the delay between onset of symptoms or hospital admission and surgery; indeed the operating time decreased with increasing preoperative delay. However, success was related to increasing operative experience (p = 0.001). CONCLUSIONS: VAT decortication is a feasible new technique to achieve lung reexpansion in chronic postpneumonic @entity4327 and has perioperative benefits over thoracotomy.

Thoracoscopic decortication: a role for video-assisted surgery in chronic postpneumonic XXXX .

@entity4327 :: ('MESH:D016724', 'Disease') :: ['pleural empyema'] @entity1 :: ('9606', 'Species') :: ['patients']
@entity4327 :: (MESH:D016724,Disease) :: ['pleural empyema']
