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Introduction: Empyema thoracis is a condition in which pus and fluid from infected tissue collects in the pleural cavity. The optimal treatment of empyema thoracis, especially in the acute condition remains controversial, whether to go for a non-operative approach (antibiotics and chest tube drainage) or an early operative regimen, VATS (Video-assisted thoracoscopic surgery). The study is conducted to determine the effectiveness of VATS in the treatment of acute empyema thoracis. Methods: We conducted a prospective comparative study between two methods of treatment i.e., chest tube insertion and VATS as primary intervention in the acute empyema thoracis. Each group consisted of 40 patients who were diagnosed as acute empyema thoracis during the period of January 2021 and June 2022. The duration of chest tube in-situ, hospital stay, cost, complications, success and outcomes were compared between the two groups. Results: It was found that VATS was better than the conventional chest tube insertion in terms of the mean duration of hospital stay (16.05 ± 3.58 vs 25.78 ± 4.04 days), mean duration of the chest tube in-situ (8.23 ± 2.09 vs 17.18 ± 3.30 days), mean cost of the treatment (Taka 12962.50 ± 1469.29 vs 19175.00 ± 1443.60), complications (42.5% vs 77.5%) and success rate (80% vs 45%). There was no death in any group. Conclusion: Video-assisted thoracoscopic surgery (VATS) is feasible and effective in the management of acute empyema thoracis. J Bangladesh Coll Phys Surg 2024; 42: 223-229
Hoque et al. (Sun,) studied this question.