Video-assisted thoracoscopic decortication versus open decortication for a better surgery results.

Background: Comparing video-assisted thoracoscopic decortication with open decortication: advantages anddisadvantages.Aim: In this study, we aim to compare the outcomes associated with VTASD and OD in terms of less surgical trauma andimproving postoperative pain.Patients and Methods: We did a prospective comparative study involving 60 patients with thoracic empyema. Patientswere randomly allocated to undergo Video-assisted thoracoscopic surgery (VATS) decortication or open decortication.The patients were split up into two groups, each with 30 patients: open thoracotomy (OT) and VATS. We contrasted thefrequency of postoperative pain, adjusted length of hospital stay, air leak, incomplete lung inflation, blood transfusion,wound infection, reoperation, and death following surgery.Results: Postoperative pain score using the visual analogue scale was compared in the two groups. Regarding postoperativepain, the median for VATS was 3 with an interquartile range (IQR) of 2–4, and for OT the median was 8 with an IQR of7–8 with a highly significant statistical difference. This can be the result of the intercostal neuralgia that occurs due toinjury to the intercostal nerves when access is gained to the thoracic cavity by spreading the ribs and dissecting the pleura.Owing to the procedure’s short incision, lack of rib spreading required, and minimum intraoperative manipulation, it hasbeen suggested and confirmed in the literature thus far that patients having VATS had less postoperative discomfort anda lower need for analgesics.In reference to the hospital stay, our analysis showed that the OT group median was 7–9 with an IQR of 7–9 and a highstatistically significant. Whereas the VATS group median was 5 with an IQR of 5–6.Conclusion: Video assisted thoracoscopic decortication is a safe procedure, and provides less postoperative complications,less postoperative pain, and less hospital stay which leads to better surgery results.