Video-Assisted Thoracoscopy and Open Thoracotomy for the Treatment of Stage III Empyema: A Comparative Study

VATS versus open thoracotomy in stage III empyema

Abstract

Background: Pleural empyema can be fatal and requires surgery if untreated. Stage III empyema, marked
by thickened pleura, necessitates surgical intervention. Both open thoracotomy (OT) and video-assisted
thoracoscopic surgery (VATS) are viable options, but there is insufficient clinical evidence to determine which
is superior.
Objective: This study evaluated the preoperative outcomes of VATS and OT in patients with stage III empyema
Methods: There were two groups of 30 patients with stage III empyema treated with OT or VATS. We measured
patients' preoperative characteristics and analyzed them using t-tests and chi-square tests
Results: No difference was seen between the mean (± SD) age of the OT (40.38 ± 19.71) and VATS group (43.56
± 19.82) (p-value = 0.796). The OT group's surgery and hospital stay (2.15 ± 0.58 hours) was about 1.5 times
the VATS procedure (1.44 ± 0.37 hours) (p-value = 0.018). Tachypnea duration (p-value = 0.174) and chest tube
duration (p-value = 0.417) were statistically similar between groups. OT patients experienced longer air leaks
than VATS patients (p-value = 0.019).
Conclusions: Both procedures are effective, but VATS may be preferable due to shorter operation times, hospital
stays, and its minimally invasive nature. Further clinical trials are needed for clearer guidance.