Early Thoracotomy and Decortication in Pleural Empyema

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Infectious Diseases

Background:

• Pleural empyema, a severe lung infection complication, has high morbidity and mortality.
• Early stages respond to antibiotics and drainage, but chronic empyema often necessitates surgery.
• This study focuses on early thoracotomy and decortication for advanced pleural empyema.

Purpose of the Study:

• To evaluate the outcomes of early thoracotomy and decortication for pleural empyema.
• To assess the safety and efficacy of this surgical intervention at a tertiary cardiac center in India.
• To analyze survival, complications, and functional recovery in patients with advanced pleural empyema.

Main Methods:

• Retrospective observational study of nine patients undergoing early thoracotomy and decortication (2018-2024).
• Analysis of demographics, radiological findings, etiology, complications, survival, and follow-up.
• Kaplan-Meier method used for survival and event-free survival assessment.

Main Results:

• The study included 66.7% female patients; 77.8% had non-tuberculosis (TB) related empyema.
• Postoperative complications occurred in 33.3% of patients; 11.1% mortality due to severe complications.
• 12-month survival was 88.9%, event-free survival was 66.7%, with satisfactory lung re-expansion and no recurrence in survivors.

Conclusions:

• Early thoracotomy and decortication is a safe and effective treatment for advanced pleural empyema.
• This surgical approach provides favorable survival and functional outcomes.
• Thoracotomy remains crucial for selected patients, especially in tuberculosis-endemic regions.