COMPARISON OF TUBE THORACOSTOMY VS VATS IN THE MANAGEMENT OF EMPYEMA THORACIS IN FIBRINO-PURULENT STAGE IN CASES OF PNEUMONIA & CHEST TRAUMA

SMR NAQVI; SMA SHAH; A MATEEN; IA FARHAN

doi:10.54112/bcsrj.v2023i1.363

Authors

SMR NAQVI Department of Thoracic Surgery, KEMU/Mayo Hospital Lahore, Pakistan
SMA SHAH Department of Thoracic Surgery, KEMU/Mayo Hospital Lahore, Pakistan
A MATEEN Department of Thoracic Surgery, KEMU/Mayo Hospital Lahore, Pakistan
IA FARHAN Department of Thoracic Surgery, KEMU/Mayo Hospital Lahore, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.363

Keywords:

Tube thoracostomy, VATS, Empyema thoracis

Abstract

Empyema thoracis has been considered a serious problem. Different treatment options are available for the management of empyema thoracis, and each of these procedures has its own merits and demerits. This study was designed to compare the outcome of Tube Thoracostomy and VATS in the fibrino-purulent stage of empyema due to pneumonia and chest trauma in terms of hospital stay and empyema resolution in the adult age group. Ninety patients in the study were randomly divided into two groups of equal numbers, i.e., 45 in each group, by lottery method. Patients in Group A underwent tube thoracostomy, and patients in Group B had VATS. Five days postoperatively, clinical examination and relevant investigations like CXR, USG Chest of all patients were done to find empyema resolution. The mean age, BMI, and duration of hospital stay of the patients in group A vs. B was 36±16.5 vs 28±11.4, 26.03±3.39 and 26.1±3.63 and 10±4.1 vs 5±1.24 respectively. In Group A vs. B, there were 96.7% vs. 80% males and 3.3% vs 20% females, respectively. Resolution of symptoms of empyema in group A vs. B was seen in 26.7% vs. 43.3% respectively (p=0.005). Short duration of hospital stay was seen in 15% vs. 48.3% of patients in Group A vs. B, respectively (p=0.000). The Fibrino-purulent stage of Empyema Thoracis, VATS, and Decortication led to early resolution compared to tube thoracostomy alone.

Downloads

Download data is not yet available.

References

Ahmed, A., and Yacoub, T. (2010). Clinical Medicine Insights: Circulatory. Respiratory and Pulmonary Medicine 4, 1-8.

Bhatnagar, R., and Maskell, N. A. (2013). Treatment of complicated pleural effusions in 2013. Clinics in Chest Medicine 34, 47-62.

Christopoulou-Aletra, H., and Papavramidou, N. (2008). “Empyemas” of the thoracic cavity in the Hippocratic Corpus. The Annals of thoracic surgery 85, 1132-1134.

Elsayed, H. H., Mostafa, A., Fathy, E., Diab, H. S., Nofal, I. M., AbdelHamid, O. A., El-Bawab, H. Y., and ElNori, A. A. (2018). Thoracoscopic management of early stages of empyema: is this the golden standard? Journal of Visualized Surgery 4.

König, H.-H., Bernert, S., Angermeyer, M. C., Matschinger, H., Martinez, M., Vilagut, G., Haro, J. M., de Girolamo, G., de Graaf, R., and Kovess, V. (2009). Comparison of population health status in six european countries: results of a representative survey using the EQ-5D questionnaire. Medical care, 255-261.

Kumar, V., Thakur, V. K., Chaubey, D., Rahul, S. K., Yadav, R., Hasan, Z., Prasad, R., Kumar, D., and Pallavi, K. (2019). Management of Empyema Thoracis in Paediatric Population-A Tertiary Centre Experience. Journal of Indira Gandhi Institute Of Medical Science 5, 13-16.

Porcel, J. M. (2010). Pleural fluid tests to identify complicated parapneumonic effusions. Current opinion in pulmonary medicine 16, 357-361.

Shin, J. A., Chang, Y. S., Kim, T. H., Haam, S. J., Kim, H. J., Ahn, C. M., and Byun, M. K. (2013). Surgical decortication as the first-line treatment for pleural empyema. The Journal of Thoracic and Cardiovascular Surgery 145, 933-939. e1.