Decortication as an Option for Empyema Thoracis.

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Infectious Diseases

Background:

• Empyema thoracis is a significant thoracic infection.
• Decortication is a key surgical intervention for managing empyema.

Purpose of the Study:

• To analyze the outcomes and morbidity associated with decortication procedures for empyema thoracis.
• To compare open decortication with video-assisted thoracic surgery (VATS) decortication.

Main Methods:

• Retrospective case series of 812 patients undergoing open or VATS decortication for empyema thoracis.
• Procedures performed between January 2006 and March 2018.
• Exclusion criteria included patients unfit for one-lung ventilation, those undergoing local anesthesia procedures, clotted hemothorax, and malignant pathology.

Main Results:

• Open decortication was performed in 650 patients (80%), while VATS decortication (VATD) was used in 162 cases.
• Blood transfusion was required in 40.7% of patients.
• Tuberculosis was diagnosed in 47.3% of cases via histopathology, with an overall mortality of 1.3%.

Conclusions:

• Open decortication remains a preferred surgical approach for empyema thoracis, particularly in developing countries.
• Video-assisted thoracic surgery decortication is gaining wider utilization for empyema management.