TY - JOUR
T1 - Thoracotomy and decortication
T2 - impact of culture-positive empyema on the outcome of surgery
AU - Okiror, Lawrence
AU - Coltart, Cordelia
AU - Bille, Andrea
AU - Guile, Lucy
AU - Pilling, John
AU - Harrison-Phipps, Karen
AU - Routledge, Tom
AU - Lang-Lazdunski, Loic
AU - Hemsley, Carolyn
AU - King, Juliet
PY - 2014/11
Y1 - 2014/11
N2 - OBJECTIVES: This study aimed to assess the efficacy of thoracotomy and decortication (T/D) in achieving lung re-expansion in patients with Stage III empyema and assess the impact of culture-positive empyema on the outcome of decortication.METHODS: This is a retrospective observational study of consecutive patients treated with T/D over a 6-year period.RESULTS: A total of 107 consecutive patients were identified. The median age was 55 (range 16-86) years; of which, 86% were male. The median length of hospital stay was 9 (range 2-45) days. Full lung re-expansion was achieved in 86% of cases. There were no postoperative deaths. Pleural cultures were positive in 56 (52%) cases. Patients with culture-positive empyema had a longer duration of pleural drainage (median of 11 days, range 3-112 versus median of 5 days, range 3-29 days for negative culture; P = 0.0004), longer length of hospital stay (median of 11 days, range 4-45 versus median of 7 days, range 2-34 days; P = 0.0002) and more complications (P = 0.0008), respectively. There was no statistically significant difference in the outcome of surgery, i.e. lung re-expansion versus trapped lung (P = 0.08) between the two groups.CONCLUSIONS: T/D is safe and achieved lung re-expansion in the majority of patients. Culture-positive empyema was associated with worse outcomes.
AB - OBJECTIVES: This study aimed to assess the efficacy of thoracotomy and decortication (T/D) in achieving lung re-expansion in patients with Stage III empyema and assess the impact of culture-positive empyema on the outcome of decortication.METHODS: This is a retrospective observational study of consecutive patients treated with T/D over a 6-year period.RESULTS: A total of 107 consecutive patients were identified. The median age was 55 (range 16-86) years; of which, 86% were male. The median length of hospital stay was 9 (range 2-45) days. Full lung re-expansion was achieved in 86% of cases. There were no postoperative deaths. Pleural cultures were positive in 56 (52%) cases. Patients with culture-positive empyema had a longer duration of pleural drainage (median of 11 days, range 3-112 versus median of 5 days, range 3-29 days for negative culture; P = 0.0004), longer length of hospital stay (median of 11 days, range 4-45 versus median of 7 days, range 2-34 days; P = 0.0002) and more complications (P = 0.0008), respectively. There was no statistically significant difference in the outcome of surgery, i.e. lung re-expansion versus trapped lung (P = 0.08) between the two groups.CONCLUSIONS: T/D is safe and achieved lung re-expansion in the majority of patients. Culture-positive empyema was associated with worse outcomes.
KW - Bacterial culture
KW - Stage III empyema
KW - Thoracotomy and decortication
UR - http://www.scopus.com/inward/record.url?scp=84933521190&partnerID=8YFLogxK
U2 - 10.1093/ejcts/ezu104
DO - 10.1093/ejcts/ezu104
M3 - Article
C2 - 24634483
AN - SCOPUS:84933521190
SN - 1873-734X
VL - 46
SP - 901
EP - 906
JO - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
IS - 5
ER -