Late Paediatric Empyema Thoracic Decortication Using Muscle Sparing Axillary Skin Crease Incision (Msasci)

Abstract

Objective: The aim of this study is to determine the effectiveness of muscle sparing axillary skin incision (MISASCI) among patients of late paediatric empyema thoracic were undergone decortication. Study Design: A prospective study Place and Duration: The study was conducted at Children Hospital and Institute of Child Health Lahore and Women and Children Hospital Rajjar, Charsada during the period from December 2020 to May 2021. Methods: Total 50 children of both genders were presented in this study. Patients were aged 1 month-12 years. Patients’ detailed demographics age, sex and weight were calculated after taking informed written consent from authorities. Patients had late paediatric empyema thoracic were enrolled. MSASCI was used for decortication among all cases. Effectiveness of incision was calculated post-operatively in terms of visibility and size of scar, intraoperative exposure and access to the lobes. Complete data was analyzed by SPSS 23.0 version. Results: There were 30 (60%) male and 20 (40%) females with mean age 7.14±7.44 years. Mean body weight of the children was 16.58±9.74 kg. We found pyopneumothorax in 20 (40%), followed by encysted empyema in 12 (24%), multiloculated empyema in 9 (18%), bilateral Empyema thorax in 5 (10%),and diaphragmatic hernia in 4 (8%). Adequate exposure was seen among 49 (98%) cases. Chest tube was removed within 5.87±4.54 days. Good lung expansion was found in 47 (94%) cases. Air leak was found among 6 (12%) cases. Frequency of scars was very low only among 4 (8%) cases. Conclusion: We concluded in this study that MSASCI was effective for decortication among patients of late paediatric empyema thoracic in terms of post-operative good lung expansion, adequate exposure with minimum numbers of scars and less complications i.e air leak in all cases. Keywords: MSASCI, Paediatric Empyema Thoracic, Decortication, Complications