Decortication of the Lung

Abstract

From 1972 to 1982, 161 patients underwent pleural decortication because of pleural callosity with or without empyemic residual cavities. Indications were: Sanitation of infection sites and improvement of respiratory function. Of the patients, 73.3% had non-specific and 22.4% tubercular empyema. Postoperative complications included 8.7% wound infections and 1.2% recurring empyema. Operative mortality was 1.2%. To estimate pulmonary function, the preoperative values of blood gas analysis, vital capacity, forced expiratory volume and maximal voluntary ventilation were assessed and compared with those obtained early postoperatively and after one year in 75 patients. The average values of these measurements showed no significant improvement in postoperative pulmonary function. A relatively slight improvement (mean 13.8%) showed only in those patients who had a preoperative reduction of vital capacity of more than 40%. The indication for decortication to improve pulmonary function alone is questionable. As a rule it is based upon 2 factors--both elimination of infectious foci and improving function.

Lung Function in Patients Operated for Chronic Pleural Empyema

“…The conclusions are not uniform due to different patient populations and numbers. In the studies where tuberculosis was the main etiologic factor of CPE, no functional recovery was observed after decortication [9]. Toomes et al showed that mean FVC values were not increased in patients with a preoperatively predicted FVC higher than 60% [10].…”

Dekortikation bei Pleuraempyem: funktionell sinnvoll?

“…Entsprechend der Einteilung der American Thoracic Society (ATS) wird nach dem natürlichen Verlauf zwischen 3 Phasen (exsudativ, fibrinopurulent und Organisationsphase) unterschieden [9]. Insbesondere im fortgeschrittenen Stadium kann nur durch eine operative Intervention eine Ausheilung erzielt werden [10]. Bei Patienten mit PE im Stadium II-III und gegebener funktioneller Operabilität besteht entsprechend der European Association for Cardio-Thoracic Surgery (EACTS) die Empfehlung (Klasse I Level B) zur chirurgischen Intervention via videoassistierter Thorakoskopie (VATS).…”

Outcomes of pleural decortication in a tertiary care hospital of Telangana state

“…In their study Toomes et al found that 8.7% of patients with wound infection complications 1.2% with air leaks and 1.2% with recurring empyema. 26 In our study only 4 (8%) patients developed wound site infection complications. All the patients were given 3 rd generation I.V cephalosporins preoperatively to contain infection.…”