Clinical Efficacy Of Thoracoscopic Surgery In The Treatment Of Early Empyema

Objective: To discuss the role and value of thoracoscopic surgery in the treatment of empyema.Methods: Selected from October 2015 to May 2018 which in The Second hospital of Dalian Medical University and surgical treatment of a total of 69 patients who were treated surgically in the Department of Thoracic Surgery.There were 33 patients in the thoracoscopic surgery group and 36 patients in the thoracotomy group.The general clinical data of operation time,volume of blood transfusion,the length of hospital stay,postoperative drainage,postoperative time of catheterization and incidence of complications were analyzed.SPSS22.0 statistical software package was used for statistical analysis of data: after normal test of measurement data.Median(quartile spacing)and Wilcoxon rank sum test were used to describe the measurement data which conformed to the normal distribution.Rate or constituent ratio was used to describe the counting data.Chi-square test was used for comparison among different groups.All hypothesis tests showed significant difference with P <0.05.To compare the clinical differences between the two groups..Results: The operation time(120(90-180)mins in thoracotomy group,90(76-120)mins in laparoscopy group,P=0.004),the use of analgesics(10(8-14)times in thoracotomy group,8(6-10)times in laparoscopy group,p<0.001),the length of time after operation(14(13.5-15.5)days in thoracotomy group,10(10-12.5)days in laparoscopy group,p<0.001),the time of tube-carrying and the time after operation(10-12.5)days in thoracotomy group,p<0.001).The incision length(15(10-15)cm in thoracotomy group and 4(4-4)cm in endoscopy group)was significantly different(P < 0.05).There were no significant differences in the voluem of blood transfusion(400(0-620)ml in thoracotomy group,0(0-910)ml in endoscopy group,P=0.686),incidence of complications,short-term drainage(900(600-1430)ml in thoracotomy group,840(572.5-1110)ml in endoscopy group,P=0.484.Conclusion: 1.Video-assisted thoracoscopic thoracotomy is effective in the removal of empyema,and the short-term effect is consistent with that of open thoracotomy.2.Compared with thoracotomy,thoracoscopic pyothorax clearance has shorter operation time,indwelling drainage time and hospital stay.3.Video-assisted thoracoscopic surgery for empyema removal has good effect and conforms to the concept of ERAS,which is worthy of promotion.