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Application of thoracoscopic surgery in patients with pleural empyema

Daniel Bulyashki


A retrospective analysis of the video-assisted thoracoscopic surgery performed on 46 patients at a mean age of 49.61 ± 18.96 years with pleural empyema during the period between January 1, 2016 and November 30, 2022 in the Clinic of Thoracic Surgery at the Department of Surgery and in the Department of General and Operative Surgery of the Medical University of Varna was carried out. The patient group consisted of 35 males at a mean age of 48.00 ± 18.88 years and 11 females at a mean age of 54.73 ± 20.25 years. A right or a left stage II pleural empyema without bronchopulmonary fistula was diagnosed in 22 males and in two females, a right or a left stage II pleural empyema stage with fistula—in seven males and in four females, a right or a left stage III pleural empyema without fistula—in five males and in two females, a right or a left stage III pleural empyema with fistula—in one male and in two females, while a stage II bilateral pleural empyema without fistula was found out in one female patient. The video-assisted thoracoscopic surgery was performed along with debridement, decortication, lavage, and drainage in all the patients. The postoperative period was uneventful and the duration of postoperative drainage and hospital stay was short. There were no postoperative complications and perioperative lethality. Based on the very good results obtained from the use of the video-assisted thoracoscopic surgery in pleural empyema patients, a broader application of this contemporary method in Bulgarian practice could be recommended. 



pleural empyema; video-assisted thoracoscopic surgery; retrospective analysis

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