Feasibility and Effectivity of Video-Assisted Thoracoscopic Surgery (VATS) in the Management of Acute Empyema Thoracis
Acute thoracis empyema is an ancient disease condition that continues to be an important clinical problem worldwide. It is characterized as active inflammation and effusion between the parietal and visceral pleural spaces that progresses from stage I (exudative), through stage II (fibrinopurulent), to stage III (chronic organized) for 3 to 6 weeks.1 Thoracic empyema is mainly secondary to pneumonia. According to clinical studies, 50-70% of individuals with pneumonia develop parapneumonic effusion (Stage I), 20% develop pleural empyema in a fibrinopurulent or organized stage (Stage II or III), and 5-10% develop empyema thoracis despite receiving antibiotics.2 Other etiologies of empyema include blunt or penetrating chest trauma, tuberculosis, mediastinitis with pleural extension, postsurgical etiologies, etc. Since Bangladesh is 1 of the 5 countries that contribute over half of the world’s pneumonia cases and timely identification of acute thoracis empyema is critical to treatment outcomes, healthcare professionals should be familiar with thoracic empyema phases, diagnostic tools, and management protocols. 3,4