Zentralbl Chir 2018; 143(S 01): S102
DOI: 10.1055/s-0038-1668395
Poster
Georg Thieme Verlag KG Stuttgart · New York

Evaluation of Changes in Pulmonary Function following Decortication of Lung in Chronic Empyema Thoracis: A Prospective Observational Study

L Patel
1   Max Super Speciality Hospital, W-3, Sector 1, Vaishali, India
,
R Dutta
1   Max Super Speciality Hospital, W-3, Sector 1, Vaishali, India
,
RCM Kaza
1   Max Super Speciality Hospital, W-3, Sector 1, Vaishali, India
,
S Joshi
1   Max Super Speciality Hospital, W-3, Sector 1, Vaishali, India
,
PL Patel
2   37/Pankaj Society, Part 1, Near Gayatri Temple, India
› Author Affiliations
Further Information

Publication History

Publication Date:
05 September 2018 (online)

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Hintergrund:

The aim of the study was to evaluate pulmonary function before and after thoracotomy with decortication of lung in patients with chronic empyema thoracis secondary to any etiology except malignancy.

Material und Methode:

Twenty five patients with chronic empyema thoracis were evaluated in a prospective manner. The patients were assessed with history, physical examination, pulmonary function test with spirometry, arterial blood gas analysis and exercise test using 6 minute walk test before and after thoracotomy with decortication of lung (with or without segmental rib resection) at 1 and 3 months. Pain was assessed using the visual analogue scale.

Ergebnis:

Twenty one patients (84%) were males and 4 (16%) were females. The maximum numbers of patients were 30 years and younger (12, 48%) with the mean age being 32.24 years (SD ± 11.18). The most common symptom was cough (21, 84%), followed by fever (18, 72%) and chest pain (16, 64%). The most common cause of chronic empyema thoracis was found to be tuberculosis (18, 72%). More than half patients (15, 60%) had comorbidities, the most common one being anemia (14, 56%). The mean preoperative forced expiratory volume in first second (FEV1) increased from 44.72% to 58.48% and 71.16% postoperatively at 1 and 3 months respectively (p < 0.0001). Similarly, the mean preoperative forced vital capacity (FVC) increased from 44.6% to 58.84% and 71.52% postoperatively at 1 and 3 months respectively (p < 0.0001). The mean preoperative FEV1/FVC Ratio also increased from 86.38 to 87.85 and 88.72 postoperatively at 1 and 3 months respectively (p < 0.0001). The mean preoperative partial pressure of oxygen (pO2) increased from 80.59 to 85.18 and 88.32 mmHg postoperatively at 1 and 3 months respectively (p < 0.0001). The mean preoperative percentage of predicted distance covered (during 6 minute walk test) increased from 48.8% to 61.52% and 73.13% postoperatively at 1 and 3 months respectively (p < 0.0001). There was significant decrease in chest pain at 1 and 3 months after the surgery.

Schlussfolgerung:

Thoracotomy with decortication of lung results in significant improvement in FEV1, FVC, FEV1/FVC Ratio, pO2 and the predicted distance covered. Surgical treatment achieves excellent respiratory outcomes in patients with chronic empyema thoracis.