Surgical management of empyema thorasis : A 7 year experience in Christian Medical College Hospital, Vellore

Abstract

Aim and Objectives: To study the surgical management of empyema thoracic. Material and methods: 321 cases of empyema thoracic surgically treated in our institution. Age and sex distribution, risk factors, pre operative investigations,  type of surgical procedure performed, post operative complications, post operative length of hospital stay and post operative follow up of all patients were analyzed retrospectively with statistical tests like chi square test and students t test. Results: Among the 230 cases of empyema, there were 267 male (85.7%) and 54 female (14.3%) patients, most of the patients were in their third or fourth decades.  Among the total of 321 patients, 180 patients (54.7%) had previous history of ICD insertion. In this study, only 45 patients were smokers (9.5).There were 185 tuberculosis patients (45.6) in our study.  The most common presenting complaints were cough(54.7%),Out of the 321  patients, 88  patients (27 %) showed the presence of organisms in the pre operative pleural fluid culture. Mixed growth of organisms was the most common in pre operative culture, followed by Pseudomonas and Non fermenting Gram negative bacillus.Among the 321 patients who underwent surgical procedures, 182 patients had undergone window procedure among which  82 patients had active tuberculosis, 103 patients had undergone decortication procedure. Conclusion: Majority of the patients in our study had undergone window procedure and decortication.Most of the tuberculosis patients ended up with window procedure. Tuberculosis had significant impact on the post operative length of hospital stay. Moreover, mortality in our study was low. Since patients come from distant places, their post operative follow up was not satisfactory.