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Management of tuberculous empyema
1Division of Thoracic Surgery, King Khalid University Hospital, P.O. Box 7805, Riyadh, Saudi Arabia. alkattan@ksu.edu.sa
Summary
This study reviewed 26 tuberculous empyema cases to establish a treatment protocol. Staging guided treatment, achieving full recovery with minimal invasiveness and acceptable hospital stays.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Infectious Diseases
Background:
- Tuberculous empyema is a serious condition requiring effective treatment protocols.
- Retrospective review of 26 cases over 3 years aimed to establish such a protocol.
Purpose of the Study:
- To establish a treatment protocol for tuberculous empyema.
- To guide surgical treatment based on empyema stage and underlying lung condition.
Main Methods:
- Retrospective review of 26 patients (1996-1998) with tuberculous empyema.
- Management based on empyema stage: aspiration, intercostal tube (ICT) drainage, thoracoscopic drainage, streptokinase installation, decortication, window, lobectomy, or pneumonectomy.
- Chest computerized scan used for all patients.
Main Results:
- Exudative empyema: aspiration +/- ICT drainage.
- Fibrinopurulent empyema: thoracoscopic drainage (mean stay 8 days).
- Organizing empyema: varied interventions including ICT, streptokinase, decortication, window, lobectomy, pneumonectomy. All patients recovered fully with no mortality; mean drainage duration 18 days.
Conclusions:
- Empyema stage and lung condition dictate surgical approach.
- Protocol aims for cure with least invasive methods and acceptable hospital stay.