Effect of decortication and pleurectomy in chronic empyema patients

Bagheri, Reza; Haghi, Seyed Ziaollah; Dalouee, Marziyeh Nouri; Rajabnejad, Ata’ollah; Basiri, Reza; Hajian, Tahereh

doi:10.1177/0218492316629281

Cited by 16 publications

(12 citation statements)

References 20 publications

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“…A significant improvement in follow-up pulmonary function test values was observed compared with preoperative values (p < 0.001) as in Table 5. The observed change was comparable with a previous study [14].…”

Section: Commentsupporting

confidence: 92%

Thoracoscopic Decortication of Stage III Tuberculous Empyema Is Effective and Safe in Selected Cases

Kumar

Asaf

Lingaraju

et al. 2017

The Annals of Thoracic Surgery

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Section: Commentsupporting

confidence: 92%

Thoracoscopic Decortication of Stage III Tuberculous Empyema Is Effective and Safe in Selected Cases

Kumar

Asaf

Lingaraju

et al. 2017

The Annals of Thoracic Surgery

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“…pulmonary functions significantly 4,[11][12][13] . Bagheri et al 4 studied 50 cases with chronic empyema and performed posterolateral thoracotomy in all patients. He pointed out that both FEV1 and FVC improved significantly after the operation.…”

Section: Discussionmentioning

confidence: 96%

“…Thickened pleura causes decreased thoracic wall compliance and even thoracic deformity. The fundamentals of the treatment are to remove the cortex on the parenchyma to provide the lung to re-expand and to remove the thickened pleura to provide the chest wall its mobility, especially relieve the diaphragm to be able to contract again 4 .…”

Section: Discussionmentioning

confidence: 99%

The Physiologic and Radiologic Outcomes of Decortication for Chronic Empyema in the Long Term Follow Up: A Retrospective Analysis

Kutluk¹,

Akın²,

Erdoğdu³

2019

Kafkas J Med Sci

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Aim: Chronic empyema due to non-specific or tuberculosis lead to both decrease in pulmonary functions and distortions of the radiologic views. Decortication either through video assisted thoracic surgery (VATS) or open thoracotomy is the last resort of treatment. The study aims to evaluate the spirometry and radiologic outcomes of decortication of patients with chronic empyema. Material and Method: The study included all patients who had decortication due to thoracic empyema between 2010 and 2016. Besides routine clinical evaluation spirometry analyses and radiologic evaluation with thoracic computerized tomography (CT) were performed in all patients. Either open thoracotomy with muscle sparing technique or VATS were performed to remove thickened parietal pleura and to decorticate the thickened pleura trapping the lung parenchyma. Change in the spirometry parameters were calculated. The improvement in the radiologic appearance were classified as satisfactory, moderately satisfactory, and unsatisfactory. Results: A total of 104 patients comprised the study population. Sixty-eight of the cases (65%) were male and the mean age of patients was 38.61±17.38 years. Operation site was equally distributed. Non-specific microorganisms were the dominant etiologic agents rather tuberculosis. All spirometry parameters improved significantly. Both forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) values increased after the decortication significantly. All patients were followed at least for 2 years. Most of the cases showed satisfactory results (92 cases, 88%), 9 patients improved moderately (8.6%), and only 3 patients (3%) had unsatisfactory radiologic evaluation. Conclusion: Decortication either through open thoracotomy or VATS approach is very effective treatment method to improve the spirometry parameters and restore the distorted radiologic appearances in patients with chronic empyema.

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“…Along with the PO‐LOS, we wanted to analyze other clinical indicators of the procedure performance. The reduction in thoracic volume has been considered as a measure of lung function and chest mobility impairment due to pleural infection 24–26 . Both studies of Bagheri et al 25 and Gokce et al 24 reported an enlargement of the hemithorax diameters after full decortication of the lung for Stage 3 empyema.…”

Section: Discussionmentioning

confidence: 99%

Tracking the outcomes of surgical treatment of Stage 2 and 3 empyema: introduction and consolidation of minimally invasive approach

Patella

Minerva

Porcellini

et al. 2021

ANZ Journal of Surgery

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Background We described the results of surgical treatment of empyema, tracing outcomes throughout the passage from the open thoracotomy (OT) approach to video‐assisted thoracoscopic surgery (VATS) in a single institute. Methods We retrospectively analyzed the records of 88 consecutive patients treated for Stage 2 and 3 empyema (2010–2019). We divided the study period into three groups: OT period (2010–2013), early VATS (2014–2017, from the introduction of VATS program, until acme of learning curve), and late VATS (2018–2019). Groups were compared to investigate the outcomes evolution. Results Most relevant findings of the study were significant variation in postoperative length of stay (median [interquartile range]: 9 days [7.5–10], 10 [7.5–17.5], and 7 [5–10] for OT period, early VATS, and late VATS, respectively, p = 0.005), hospital admission referral to thoracic surgery interval (7.5 days [4.5–11], 6.5 [3–9], and 2.5 [1.5–5.5], p = 0.003), chest tube duration (5.5 days [5–7.5], 6 [4–6], 4 [3–5], p = 0.003), and proportion of operation performed by residents (3 [15%], 6 [16.7%], 14 [43.6%], p = 0.01). Conclusions Our findings pictured the trajectory evolution of outcomes during introduction and consolidation of VATS treatment of empyema. During the early phase, we observed a decline in some indicators that improved significantly in the late VATS period. After a learning curve, all outcomes showed better results and we entered into a teaching phase.

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Effect of decortication and pleurectomy in chronic empyema patients

Abstract: Decortication and pleurectomy via a posterolateral thoracotomy significantly improves pulmonary function and chest wall diameters in patients with chronic empyema due to tuberculosis or other diseases.

Cited by 16 publications

References 20 publications

Thoracoscopic Decortication of Stage III Tuberculous Empyema Is Effective and Safe in Selected Cases

Thoracoscopic Decortication of Stage III Tuberculous Empyema Is Effective and Safe in Selected Cases

The Physiologic and Radiologic Outcomes of Decortication for Chronic Empyema in the Long Term Follow Up: A Retrospective Analysis

Tracking the outcomes of surgical treatment of Stage 2 and 3 empyema: introduction and consolidation of minimally invasive approach

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