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Thoracoplasty: an obsolete procedure?

R K Dewan1, S Singh, A Kumar

  • 1Department of Thoracic Surgery, L.R.S. Institute of TB and Allied Diseases, New Delhi.

The Indian Journal of Chest Diseases & Allied Sciences
|August 7, 1999
PubMed
Summary
This summary is machine-generated.

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Thoracoplasty remains relevant in developing countries for treating complex pulmonary tuberculosis complications like empyema and fistulas. This surgical procedure demonstrated successful outcomes in most patients, controlling sepsis and other severe symptoms.

Area of Science:

  • Pulmonary Medicine
  • Thoracic Surgery
  • Infectious Diseases

Background:

  • Chemotherapy has reduced the need for thoracoplasty in developed nations.
  • Thoracoplasty continues to be a vital surgical option in developing countries, particularly in India.
  • The study addresses the persistent challenge of pulmonary tuberculosis in resource-limited settings.

Purpose of the Study:

  • To evaluate the continued relevance and outcomes of thoracoplasty in managing complex pulmonary tuberculosis and empyema in India.
  • To analyze the indications and success rates of thoracoplasty in a developing country context.
  • To assess the safety and efficacy of thoracoplasty for conditions like tubercular empyema and bronchopleural fistula.

Main Methods:

  • A retrospective analysis of 139 patients who underwent thoracoplasty between July 1992 and June 1997.

Related Experiment Videos

  • Categorization of surgical indications including tubercular empyema, pyogenic empyema, post-operative empyema with bronchopleural fistula, drug-resistant pulmonary tuberculosis, and recurrent haemoptysis.
  • Assessment of surgical outcomes focusing on sepsis control, fistula closure, sputum conversion, and haemoptysis management.

    • Main Results:

    • Thoracoplasty was performed in 139 patients with diverse indications, predominantly tubercular empyema (84 patients) and pyogenic empyema (33 patients).
    • Successful outcomes were achieved in the majority of cases, marked by effective control of sepsis, closure of bronchopleural fistulas, sputum conversion, and cessation of haemoptysis.
    • The overall mortality rate was low, with only four deaths recorded in the series, indicating a favorable safety profile.

    Conclusions:

    • Thoracoplasty remains a crucial and relevant surgical intervention for managing severe complications of pulmonary tuberculosis in developing countries.
    • The procedure is effective in addressing conditions such as empyema and bronchopleural fistulas, offering significant clinical improvement.
    • Given the ongoing burden of pulmonary tuberculosis in developing nations, thoracoplasty should continue to be considered a valuable therapeutic option.