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It was a parallel-armed randomized control study in which 160 participants admitted to the Thoracic Surgery Department, Services Hospital, Lahore were included. The participants were divided into two equal groups (80 in each group). Uniportal Group participants underwent uniportal video assisted thoracic surgery (VATS), while multiportal Group participants were treated with multiportal video assisted thoracic surgery(VATS). Simple consecutive sampling was carried out. Expansion of lung was evaluated postoperatively at the 1st, 3rd, 7th and 15th postoperative day by chest radiograph after uniportal and multiportal VATS.
Empyema is a problem that thoracic surgeons deal in everyday practice. The main goal of treatment is evacuating the pus and fibrin deposits in the thoracic cavity for complete lung expansion. Traditionally, the surgical approach was open thoracotomy; then the multiportal video assisted thoracic surgery (VATS) approach became more common. Recently, more surgeons are adopting the uniportal VATS approach, which has become a powerful surgical tool, for the treatment of stage II empyema.
Uniportal and multiportal VATS are a feasible technique in all patients with pleural empyema requiring surgery. In this study, the investigators observed comparable postoperative success rates, no need for conversion, and successful completion of decortication via both multiportal and uniportal approaches. This transition to a single-incision technique was associated with fewer chest tubes, minimal surgical trauma, and no compromise in clinical outcomes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Uniportal Group | Experimental | Uniportal Video Assisted Thoracic Surgery group |
|
| Multiportal Group | Experimental | Multi-portal Video Assisted Thoracic Surgery group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Uniportal VATS | Procedure | Decortication of pleural empyema is done using single-port VATS |
|
| Measure | Description | Time Frame |
|---|---|---|
| complete lung expansion after decortication | Complete expansion of lung after Uniportal or Multiportal VATS was defined as, no residual pneumothorax or fluid collection on the chest radiograph, post - operatively. Lung expansion after surgery will be measured in percentages by calculating percentage of residual pneumothorax or fluid collection and was assessed using chest X-ray. Chest x-rays were performed on post-operative day 1, 3, 7 and 15. Physiologically normal and completely expanded lung is the set parameter for checking and comparing the expansion of operated lung after decortication. | 15 days |
| Measure | Description | Time Frame |
|---|---|---|
| post-operative thoracotomy site pain | Recording of post-operative thoracotomy pain at the site of uniportal or multiportal VATS was also assessed on post-operative day 1, 3 and 7. The Visual Analogue Scale (VAS) is a simple, widely used tool for measuring pain intensity. It consists of a straight line, usually 10 cm in length, with two endpoints: "0" = no pain "10" (or 100) = worst imaginable pain The patient marks a point on the line that best represents their perceived pain level. The score is then measured in millimeters or centimeters from the "no pain" end, giving a numerical value for pain intensity. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Muhammad Shoaib Nabi | SIMS, Services Hospital, Lahore | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Services Institute Of Medical Sciences, Services Hospital | Lahore | Punjab Province | Pakistan |
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This study was designed as a parallel-arm randomized controlled trial to compare the effectiveness of uniportal versus multiportal video-assisted thoracic surgery (VATS) in achieving postoperative lung expansion in patients with stage II empyema
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Allocation concealment was maintained using sealed, opaque envelopes prepared by an independent staff member not involved in patient recruitment or data collection. Blinding was applied at the outcome assessment stage, with the radiologists evaluating postoperative lung expansion unaware of the surgical approach used.
| Multi-portal VATS | Procedure | Decortication of pleural empyema is done using two or more ports with VATS |
|
| 07 days |
| ID | Term |
|---|---|
| D016724 | Empyema, Pleural |
| D004653 | Empyema |
| ID | Term |
|---|---|
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D013492 | Suppuration |
| D010995 | Pleural Diseases |
| D012140 | Respiratory Tract Diseases |
| D007249 | Inflammation |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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