OUTCOMES OF OPEN THORACIC SURGICAL DECORTICATION IN PATIENTS WITH TUBERCULOUS EMPYEMA

  • Tahir Aslam Lady Reading Hospital MTI, Peshawar Pakistan
  • Amer Bilal Lady Reading Hospital MTI, Peshawar Pakistan
  • Manzoor Ahmed Lady Reading Hospital MTI, Peshawar Pakistan
  • Mohammad Abid Lady Reading Hospital MTI, Peshawar Pakistan
  • Abdul Baseer Lady Reading Hospital MTI, Peshawar Pakistan
  • Khurshid Ahmed Baloch Prince of Songkla University, Hat Yai, Songkhla, Thailand
  • Fawad Ali Lady Reading Hospital MTI, Peshawar Pakistan
Keywords: Tuberculous empyema, decortication, empyema necessitan, chylothorax

Abstract

Objective: To analyze the outcome of open surgical decortication of tuberculous empyema patients at their late presentation.

Study Design: Cross sectional study.

Place and Duration of Study: Patients (n = 128) with tuberculous empyema were subjected to decortication for one and half year starting from July 2017 to December 2018. Pre, intra, and post-operative characteristics of all patients were studied thoroughly with a 6-month follow up evaluation of the surgical outcomes.

 Results: Preoperative conditions were as follows:  6.25% patient had Broncho pleural fistula, 90.9% patients were diagnosed with cough, 34.7 with night sweating, 64.2% chest pain and 79.6% chest tightness. Decortication was performed in all cases, with debridement of necrotic tissue and repair of air leaks in some patients. 70 (54.7%) patients went through right side decortication, whereas 56 (43.7%) patients went through left sided decortication and 2 (1.56%) patients had bilateral. Mortality was 2 (1.56%), 1 patient died of septicemia while 1 of pulmonary embolism. Whereas morbidity was 9 (7%), 3 patients had wound infection, 4 had incomplete lung expansion, 1 patient each had prolonged air leak and post-operative bleeding.

Conclusions: Delayed referral for surgery causes irreversible changes in the lung, and prolonged disease condition, which causes increased thickness of the pleura and injury to the underlying lung with a delayed recovery. Open decortication gives satisfactory results.

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Published
2020-12-16
How to Cite
Aslam, T., Bilal, A., Ahmed, M., Abid, M., Baseer, A., Baloch, K., & Ali, F. (2020). OUTCOMES OF OPEN THORACIC SURGICAL DECORTICATION IN PATIENTS WITH TUBERCULOUS EMPYEMA. PAFMJ, 70(6), 1799-1803. https://doi.org/10.51253/pafmj.v70i6.3724
Section
Original Articles