Decortication is Better Treatment Option in Chronic Pleural Empyema

Objective: The aim of present study is to evaluate the role of decortications in management of chronic pleural empyema. Methods: From July 2014 to Jan 2019, 22 patients of chronic empyema mostly due to tuberculosis who were subjected to decortication at our hospital were evaluated prospectively. Patients were subjected to detailed clinical, radiological and other diagnostic evaluation for etiology, duration of treatment and response. Decision for decortication was taken on the basis of long duration of treatment, poor response to antibiotics and antitubercular medication, atypical chest pain, intercostal tube drainage and thickness of parietal pleura. All the patients were followed up for six months except recent cases. Results: Out of 22 patients, who were subjected to decortication, 14 patients were male and 8 was female between age group (range 15-70 years). The mean duration of symptoms was 6.4 months (range 1-24 months). The mean duration of preoperative antitubercular treatment (ATT) was 4 months (range 2 weeks to 12 months). Preoperative spirometry showed moderate restriction. Postoperatively all patients showed good recovery. Spirometry after decortication showed satisfactory improvement. One case were having severe fibrosis latter on on biopsy diagnosed as carcinoma. Conclusion: Decortication is the safe and effective treatment for chronic organized empyema, enabling complete expansion of the lung.