Change in Pulmonary Function Following Decortication for Chronic Pleural Empyema.

Abstract

Chronic empyema is the final stage of the triphasic pathogenesis of empyema that is characterized by fibrin deposits in both pleural surfaces, leading to the formation of a thickened pleural peel. This restricts the lung movements, giving rise to a trapped lung and impairment of pulmonary function. The aim of this study was to determine the change in pulmonary function following decortication for chronic empyema. A total of 35 patients with chronic pleural empyema who underwent decortication via a posterolateral thoracotomy between July 2016 and July 2017 were reviewed and followed-up for 6±3 months after surgery. All patients underwent a pulmonary function test using spirometry before and after surgery. Pre-operation spirometry values [mean forced expiratory volume in 1s (FEV1) and mean forced vital capacity (FVC)] were compared with the post-operation data obtained during follow-up and the change was quantified by statistical analysis. FEV1 was 70.51% before surgery vs. 83.43% after surgery (p<0.001). FVC was 69.74% before surgery vs. 85.40% after surgery (p<0.001). There was no influence of bacteriology, side of occurrence of the lesion, smoking habit, or diabetes mellitus present before the operation on the patients' lung function (p>0.01). Decortication and pleurectomy via a posterolateral thoracotomy resulted in significant clinico-functional improvement in patients with chronic empyema, regardless of the bacteriology, side of occurrence of the lesion, smoking habit, or diabetic status of the patient.