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Change in Pulmonary Function Following Decortication for Chronic Pleural Empyema
Sujith Varghese Abraham1, Prashant Chikkahonnaiah1
1Department of Pulmonary Medicine, Mysore Medical College and Research Institute, Mysuru, India.
Turkish Thoracic Journal
|March 13, 2020
Summary
Decortication surgery significantly improves lung function in patients with chronic empyema. This procedure enhances both forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC), leading to better pulmonary function post-surgery.
Area of Science:
- Thoracic surgery
- Pulmonary medicine
- Critical care medicine
Background:
- Chronic empyema involves fibrin deposits and pleural thickening, leading to restricted lung movement and impaired pulmonary function.
- This condition represents the final stage of empyema pathogenesis, often resulting in a trapped lung.
- Surgical intervention is frequently required to address the functional limitations imposed by chronic empyema.
Purpose of the Study:
- To evaluate the impact of decortication surgery on pulmonary function in patients with chronic empyema.
- To quantify changes in spirometry parameters before and after surgical intervention for chronic empyema.
Main Methods:
- A cohort of 35 patients with chronic pleural empyema underwent decortication via posterolateral thoracotomy.
- Pulmonary function tests, including spirometry (measuring FEV1 and FVC), were conducted pre-operatively and during a 6-month follow-up period.
- Statistical analysis was used to compare pre- and post-operative spirometry values.
Main Results:
- Mean forced expiratory volume in 1s (FEV1) increased from 70.51% pre-surgery to 83.43% post-surgery (p<0.001).
- Mean forced vital capacity (FVC) improved from 69.74% pre-surgery to 85.40% post-surgery (p<0.001).
- Patient factors such as bacteriology, lesion side, smoking, and diabetes did not significantly influence lung function outcomes (p>0.01).
Conclusions:
- Decortication and pleurectomy through posterolateral thoracotomy lead to significant functional improvement in patients with chronic empyema.
- The surgical benefits are observed irrespective of the underlying bacteriology, lesion location, smoking status, or diabetic condition.
- The study demonstrates the efficacy of decortication in restoring pulmonary function in chronic empyema cases.
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