Disease Introduction
Empyema is an infectious disease in which bacteria invade the pleural cavity, forming purulent exudate that accumulates. It often occurs secondary to pneumonia, chest surgery, or trauma, and manifests as fever, chest pain, shortness of breath, and weight loss. Based on the course of the disease, it is divided into the exudative stage, the fibrinous-purulent stage, and the organizing stage. The core of treatment is to drain the pus as early and adequately as possible and control the infection. In the late stage with organizing pleura, surgical removal of the thickened pleura is necessary to restore lung re-expansion.
Cutting-edge high-precision diagnostic and treatment technologies
- Single-port VATS debridement : By 2025, many hospitals in China will routinely perform single-port minimally invasive thoracoscopic empyema debridement and pleural fibrous plasmid stripping, with only one incision and blood loss as little as 100 ml;
- Staged and precise treatment : The "Expert Consensus on the Diagnosis and Treatment of Acute Empyema in Adults" classifies the empyema into three stages: exudative stage, fibrinous purulent stage, and organizing stage. Early drainage combined with fibrinolysis is recommended, and decisive excision is recommended during the organizing stage.
- Intrapleural urokinase : Medical thoracoscopic surgery combined with intrapleural injection of urokinase to dissolve septa is being validated in a multicenter prospective randomized controlled trial for the efficacy of urokinase in complex empyema.
- FlexVATS Minimally Invasive Procedure : The 2025 review proposed minimally invasive surgical techniques such as FlexVATS and awake VATS, providing debridement options for elderly, frail, and patients who cannot tolerate general anesthesia;
- Minimally invasive treatment of tuberculous empyema : Single-port thoracoscopic removal of tuberculous occlusive empyema with fiberboard stripping has become the mainstream minimally invasive approach, significantly shortening hospital stay compared to traditional open thoracotomy.
