Randomized controlled trial.

The aim of this study is to determine the difference in outcome in patients diagnosed with complex parapneumonic effusion (stage II) and pleural empyema (stage III) who are treated with either VATS surgery or TUS guided drainage and intrapleural therapy (fibrinolytic (Alteplase) with DNase (Pulmozyme®)) as first line treatment.

• TD Christensen, M Bendixen
  Department of Cardiothoracic and Vascular Surgery & Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
• RH Petersen
  Department of Cardio-thoracic Surgery, Rigshospitalet, Copenhagen University Hospital
• PB Licht
  Department of Cardiothoracic and Vascular Surgery, Odense University Hospital
• LB Møller
  Department of Cardiothoracic Surgery, Aalborg University University Hospital
• CB Laursen
  Department of Respiratory Medicine, Odense University Hospital
• SH Skaarup
  Department of Respiratory Medicine, Aarhus University Hospital
• JUS Jensen
  Department of Respiratory Medicine, Herlev-Gentofte Hospital, Copenhagen University Hospital
• BM Bibby
  Biostatistical Advisory Service (BIAS), Faculty of Health Sciences, Aarhus Universit

• NM Rahman, EO Bedawi
  NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
• B Naidu
  Department of Thoracic Surgery, Queen Elizabeth Hospital Birmingham, UK & Institute of Inflammation and Ageing, University of Birmingham, UK

• J Davidsen
  Department of Respiratory Medicine, Odense University Hospital
• M Stenger
  Department of Cardiothoracic and Vascular Surgery, Odense University Hospital

• Department of Cardio-thoracic Surgery, Rigshospitalet, Copenhagen University Hospital
• Department of Cardiothoracic and Vascular Surgery, Odense University Hospital
• Department of Cardiothoracic Surgery, Aalborg University Hospital
• Department of Respiratory Medicine, Odense University Hospital
• Department of Respiratory Medicine, Aarhus University Hospital
• Department of Respiratory Medicine, Herlev-Gentofte Hospital, Copenhagen University Hospital
• Department of Respiratory Medicine, Aalborg University Hospital
• Department of Respiratory Medicine, Holstebro Hospital
• Department of Respiratory Medicine, Viborg-Skive Hospital
• Department of Respiratory Medicine, Horsens Hospital
• Department of Respiratory Medicine, Randers Hospital
• Department of Respiratory Medicine, Lillebaelt Hospital, Kolding
• Department of Acute Medicine, Aabenrå Hospital
• Department of Respiratory Medicine, Esbjerg Hospital
• Department of Respiratory Medicine, Naestved-Slagelse Hospital
• Department of Acute Medicine, Odense University Hospital
• Department of Radiology, Aarhus University Hospital
• Department of Radiology, Odense University Hospital

This work was supported by the Novo Nordisk Foundation (grant no.: 0065455) and Skibsreder Per Henriksen, R. og Hustrus Fond.

• Christensen T. D., Bendixen M., Skaarup S. H., Jensen J., Petersen R. H., Christensen M., Licht P., Neckelmann K., Bibby B. M., Møller L. B., Bodtger U., Borg M. H., Saghir Z., Langfeldt S., Harders S. M. W., Bedawi E. O., Naidu B., Rahman N., Laursen C. B. (2022). Intrapleural fibrinolysis and DNase versus video-assisted thoracic surgery (VATS) for the treatment of pleural empyema (FIVERVATS): protocol for a randomised, controlled trial - surgery as first-line treatment. BMJ Open. 2022;9;12(3):e054236. DOI: 10.1136/bmjopen-2021-054236.
• Christensen, T. D., Vad, H., Pedersen, S., Hvas, A-M., Wotton, R., Naidu, B. & Larsen, T. B. Venous Thromboembolism in Patients Undergoing Operations for Lung Cancer: A Systematic Review. Annals of Thoracic Surgery. 2013. DOI: doi.org/10.1016/j.athoracsur.2013.10.074.