Respiratory functional outcomes improvement with intervention in chronic empyema thoracis: a retrospective analysis.

Abstract

Chronic pleural empyema is usually a consequence of in adequate treatment of acute pleural empyema. The incidence of tubercular and post-intervention empyema has increased in underdeveloped or developing countries adding to economic burden on the society. We have performed a retrospective analysis on role of intervention in chronic empyema to improve respiratory functional outcomes. We retrospectively reviewed data of 115 patients of chronic tubercular and parapneumonic empyema thoracis to evaluate change in functional outcome parameters based on their treatment modalities during follow-up in department of surgery, King George's Medical University, Lucknow, India. Accordingly, four groups were made-group 1 (tube thoracostomy), group 2 (decortication by video-assisted thoracoscopic surgery (VATS)), group 3 (decortication by open thoracotomy), and group 4 (window thoracostomy followed by thoracomyoplasty). Significant improvement was noted in forced expiratory volume in one second (FEV1)% and forced vital capacity (FVC)% in all groups. In spirometry, percent change in mean FEV1 from pre-intervention to post-intervention was increase of 55.4%, 38.3%, 47.2, and 59.21% in group 1, group 2, group 3, and group 4 respectively, and percent change in mean FVC from pre-intervention to post-intervention was increase of 53.30%, 38.11%, 51.23, and 54.21% in group 1, group 2, group 3, and group 4 respectively. Our study showed that a significant increase was observed in FVC and FEV1 from pre to post among all the groups. Comparable improvement of functional outcomes with non-operative intervention in properly selected patients can be achieved.