Objective: This study aimed to evaluate the clinical and radiographic outcomes of Video-Assisted Thoracoscopic Surgery (VATS) for early-stage empyema, emphasizing the restoration of lung volume as a crucial indicator of treatment success. Methods: A retrospective analysis was conducted on patients with early-stage empyema who underwent VATS between January 2020 and June 2025. Data regarding inflammatory markers, coagulation parameters, and clinical recovery were systematically collected. A key radiographic outcome, specifically the affected lung volume, was quantitatively assessed using CT volumetry both preoperatively and postoperatively to objectively evaluate lung re-expansion. Results: Thirty patients were included in the study. VATS resulted in significant reductions in postoperative inflammatory markers including WBC, NEUT%, CRP, IL-6, D-dimer (p < 0.05). CT-based lung volume increased significantly from 1278.81 cm³ (IQR 1021.9–1677.56) preoperatively to 1587.81 cm³ (IQR 1320.51–1978.91) at 3 months postoperatively, representing a median absolute increase of 309.0 cm³ (+24.2%, p = 0.002). The mean duration of chest tube drainage was 7.47 ± 3.96 days, and the mean length of hospital stay was 19.70 ± 8.35 days. The 30-day readmission rate was 23.33%. Conclusion: VATS is a highly effective intervention for early-stage empyema, resulting in significant resolution of systemic inflammation and, importantly, a substantial increase in lung volume. The restoration of lung volume substantiates the procedural efficacy of VATS in facilitating mechanical lung liberation and promoting functional recovery, thereby highlighting its essential role in the management of this condition.
Yue et al. (Fri,) studied this question.
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