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Uniportal VATS Decortication for Late-Stage TB Empyema
Elkhayat H. Uniportal VATS Decortication for Late-Stage TB Empyema. July 2025. doi:10.25373/ctsnet.29621030
This video submission is from the 2025 CTSNet Instructional Video Competition. Watch all entries from the competition, including the winning videos.
A 23-year-old man presented with chest pain, fever, and a dry cough lasting more than two months. His chest X-ray, CT scan, and chest ultrasound showed a left loculated empyema with complex separations. All laboratory investigations were negative for tuberculosis (TB) and other specific infections. The authors decided to perform a uniportal thoracoscopic decortication.
Minimal edits were made to the video, along with a detailed narration of the surgical steps and their rationale. The total operative time was 106 minutes. The chest tube duration was seven days, and the total hospital stay was eight days. Specimen histopathological examination confirmed TB empyema, and the patient underwent a six-month course of anti-TB treatment, with an uneventful follow-up.
His follow-up evaluations indicated improvement in symptoms, allowing a return to usual daily activities within the second postoperative week. A CT scan performed three months postoperative showed good resolution of the empyema, with only a small residual thickening of the pleura at the diaphragmatic surface.
References
- Elkhayat H, Gamal M, Ahmed Y, Aboelfadel A, Omer A. Uniportal thoracoscopic decortication: start away from empyema approach. Mini-invasive Surg. 2022;6:27. http://dx.doi.org/10.20517/2574-1225.2022.11
- Hussein Elkhayat, Mahmoud Sallam, Maiada Kamal, Esam M. Abdalla, Thoracoscopic decortication for stage III empyema; a minimal invasive approach in a delayed presentation disease, Journal of the Egyptian Society of Cardio-Thoracic Surgery, Volume 26, Issue 4, 2018, Pages 301-307, ISSN 1110-578X, https://doi.org/10.1016/j.jescts.2018.10.003.
- Elkhayat H. Uniportal VATS approach for treatment of empyema: Challenges and recommendations. Multimedia Manual of Cardiothoracic Surgery : MMCTS. 2018 Nov;2018. DOI: 10.1510/mmcts.2018.058. PMID: 30480388.
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