Thoracoscopy in management of postpneumonic pleural infections.

With expanding overall experience of video-assisted thoracic surgery in the last decade, its use in postpneumonic pleural infection is increasing, as shown by a larger number of publications advocating its efficacy. The main areas of study in the use of video-assisted thoracic surgery in this condition are (1) as an alternative to traditional open thoracotomy and (2) as an additional treatment option in the management of earlier-stage disease. The benefits of the minimally invasive approach are particularly attractive in the treatment of pediatric pleural infection. Controversy surrounds its comparative benefits over intrapleural fibrinolysis in early exudative or fibrinopurulent pleural empyema and its usefulness in the treatment of chronic pleural empyema.