Mohammad Imran, Abdul Baseer, Aamir Bilal.
Surgical outcome of Decortication for Empyema Thoracic: Peshawar experience of 2252 cases over a ten years period.
Pak J Surg Jan ;30(2):115-9.

Objective: To assess the outcome of surgical management of empyema thoracic treated by open decortication. Study design: Retrospective observational study Sett ing and duration: Cardiothoracic Surgery Unit, Post Graduate Medical Institute, Lady Reading Hospital Peshawar, from Jan 2003 to October 2013. Methodology: Computerized clinical record of 2252 patients who underwent open decortication for empyema thoracic from Jan 2003 to October 2013 was retrospectively analyzed. Patient of all ages, both sexes and diagnosed empyema thoracic were included. Medically unfi t, empyemas due to malignant pleural eff usion, empyema due to clott ed hemothorax were excluded from the study. All patients were admitt ed through outpatient department. All patients underwent decortication by conventional posterolateral thoracotomy. . Follow up done in all cases from 15 days to two months post operatively. Results: Out of 2252 patients, 1518 (67.40%)patients were male and 734 (32.59%) were female, age ranges from 2 to 71 years with a mean age of 33.12 years.1345 patients (59.72%) underwent right thoracotomy and 907 patients( 40.27%) had left thoracotomy. Bronchopleural fi stula was present in 508 (22.55%) patients and empyema necessitans in 198 (8.79%). Pneumonia and pulmonary tuberculosis were seen in 980 (43.51%) and 1272 (56.48) cases respectively. Mean duration of postoperative chest drain was 14 days. Follow-up ranged from 15 days to 2months. Morbidity is 167 (7.41%) including wound infection 92, air leak, bleeding 12 and failed decortication in 22 patients. Mortality was 43(1.90%) including respiratory failure 32, pulmonary embolism 8 and myocardial infarction in 03 patients. Conclusion: Delayed referral causes irreversible changes in the lung prolonging recovery and increasing complication rate. Meticulous decortication gives gratifying results.

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