Thoracotomy vs. Thoracoscopy For Empyema: A Retrospective Study

Beheshti Monfared, M; Eshraghi, M; Eshagh Hosseini, S.J; Shamekhi Amiri, M; Ghasemi, Sh

Thoracotomy vs. Thoracoscopy For Empyema: A Retrospective Study

Document Type : Original Article

Authors

M Beheshti Monfared ¹

M Eshraghi ²

S.J Eshagh Hosseini ³

M Shamekhi Amiri ⁴

Sh Ghasemi ⁵

¹ Department of Surgery, School of Medicine, Shahid Beheshti Hospital, Qom University of Medical Sciences

² Associate Professor, Department of Thoracic Surgery, Faculty of Medicine, Qom University of Medical Sciences, Shahid Beheshti Hospital

³ Associate Professor of Colorectal Surgery, Department of Surgery, School of Medicine, Qom University of Medical Sciences

⁴ Assistant Professor, Department of Vascular Surgery and Endovascular Therapy, Faculty of Medicine, Qom University of Medical Sciences, Beheshti Hospital of Qom, Qom, Iran

⁵ Assistant Professor of Biostatistics, Department of Biostatistics and Epidemiology, School of Health, Qom University of Medical Sciences

Abstract

Background and Objective: Empyema is characterized by a pus-filled collection in the thoracic cavity, usually resulting from an infection in the pleural space, often due to bacterial pneumonia. This study aims to compare the complications, pain intensity, length of hospitalization, and outcomes associated with two treatment methods, thoracotomy and thoracoscopy, in patients with stage 2 empyema.
Materials & Methods: This retrospective cohort study included patients hospitalized at Shahid Beheshti Hospital in Qom, Iran, from 2021 to 2023. Sampling was performed using a two-stage stratified random method. Patient information, including medical history, clinical examinations, and demographic data, was recorded. Statistical analyses were conducted using SPSS software, with a significance level set at 0.05.
Results: Baseline demographic and clinical characteristics were comparable between the two groups. Patients who underwent thoracoscopy had significantly lower postoperative pain scores (4.87 ± 1.1 vs. 8.8 ± 0.5; P = 0.001), shorter hospital stay (3.47 ± 0.6 vs. 7.03 ± 0.5 days; P = 0.001), faster surgical site healing (1.14 ± 0.46 vs. 4.43 ± 0.61 weeks; P = 0.001), and a lower 30-day readmission rate (23.2% vs. 45.5%; P = 0.001) compared with the thoracotomy group. Mortality was lower in the thoracoscopy group (0% vs. 2.7%), although the difference was not statistically significant (P = 0.081).
Conclusion: Thoracoscopy is a superior surgical approach compared to thoracotomy for managing empyema, as it results in fewer complications and promotes faster patient recovery.

Keywords

Empyema

Thoracotomy

Thoracoscopy

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