Lung India (Jan 2006)
Decortication in chronic pleural empyema
Abstract
Objective: The aim of present study is to evaluate the role of decortication in management of chronic pleural empyema. Methods: From Jan 2003 to Jun 2004, 25 patients of chronic empyema who were subjected to decortication at our tertiary care hospital were evaluated prospectively. Patients were subjected to detailed clinical, radiological and other diagnostic evaluation for etiology, duration of treatment and response. Decision for decortication was taken on the basis of long duration of treatment, poor response to antibiotics, intercostal tube drainage, thrombolytic therapy and thickness of pleural peel. All the patients were followed up for six months. Results: Out of 25 patients, who were subjected to decortication, 24 patients were male and one was female with average age 33 years (range 19-50 years). The mean duration of symptoms was 6.4 months (range 1-24 months). The mean duration of preoperative antitubercular treatment (ATT) was 5 months (range 2 weeks to 12 months). Preoperative spirometry showed moderate restriction (FVC -53%, FEV 1 -61.7%). Postoperatively all patients showed good recovery. Spirometry after decortication showed satisfactory improvement (FVC-68%, FEV 1 -72.8%). Only one patient had complication in the form of left subclavian artery injury. Conclusion: Decortication is the safe and effective treatment for chronic organized empyema, enabling complete expansion of the lung.
