Abstract | OBJECTIVES: This study aimed to assess the efficacy of thoracotomy and decortication (T/D) in achieving lung re-expansion in patients with Stage III empyema and assess the impact of culture-positive empyema on the outcome of decortication. METHODS: This is a retrospective observational study of consecutive patients treated with T/D over a 6-year period. RESULTS: A total of 107 consecutive patients were identified. The median age was 55 (range 16-86) years; of which, 86% were male. The median length of hospital stay was 9 (range 2-45) days. Full lung re-expansion was achieved in 86% of cases. There were no postoperative deaths. Pleural cultures were positive in 56 (52%) cases. Patients with culture-positive empyema had a longer duration of pleural drainage (median of 11 days, range 3-112 versus median of 5 days, range 3-29 days for negative culture; P = 0.0004), longer length of hospital stay (median of 11 days, range 4-45 versus median of 7 days, range 2-34 days; P = 0.0002) and more complications (P = 0.0008), respectively. There was no statistically significant difference in the outcome of surgery, i.e. lung re-expansion versus trapped lung (P = 0.08) between the two groups. CONCLUSIONS: T/D is safe and achieved lung re-expansion in the majority of patients. Culture-positive empyema was associated with worse outcomes.
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Authors | Lawrence Okiror, Cordelia Coltart, Andrea Bille, Lucy Guile, John Pilling, Karen Harrison-Phipps, Tom Routledge, Loic Lang-Lazdunski, Carolyn Hemsley, Juliet King |
Journal | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
(Eur J Cardiothorac Surg)
Vol. 46
Issue 5
Pg. 901-6
(Nov 2014)
ISSN: 1873-734X [Electronic] Germany |
PMID | 24634483
(Publication Type: Journal Article)
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Copyright | © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. |
Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Bacteria
(isolation & purification)
- Empyema, Pleural
(microbiology, surgery)
- Female
- Humans
- Male
- Middle Aged
- Pleura
(microbiology, surgery)
- Retrospective Studies
- Thoracotomy
(methods)
- Treatment Outcome
- Young Adult
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