• This group included 30 adult patients with stage I/II pleural empyema who operated initially by VATS.

• All patients were subjected to the following:

  1. Full history taking. 2.Full clinical examination. 3-Routine Laboratory investigations and Pleural fluid sample analysis. 4- Radiological investigations: Chest X-ray , CT chest.

• All patients will be managed by general anesthesia using double lumen endoteracheal tube to achieve single lung ventilation.

• All patients were positioned in lateral decubitus position.

• Single port skin incisions was made to pass the port through which the camera head and instruments were introduced into the chest .

• One chest tubes ws inserted as drains.

• This group included 30 adult patients with stage I/II pleural empyema who underwent conventional tube thoracotomy.

• All patients were subjected to the following:

  1. Full history taking. 2.Full clinical examination. 3-Routine Laboratory investigations and Pleural fluid sample analysis. 4- Radiological investigations: Chest X-ray , CT chest.

• The patient is placed in a supine position.

• The intercostals pace is opened .

• Chest tube is inserted in proper position regarding the site of fluid collection.

• single port video-assisted thoracoscopic surgery in the 5th intercostal space
• performed under general anesthesia.
• pleural fluid/pus was drained
• pleural adhesions was removed

Need for further method for pleural fluid drainage or decortication.

Postoperative in-hospital or follow-up death.