Lung decortication for chronic empyaema: effects on pulmonary function and thoracic asymmetry in the late period.
OBJECTIVE
Chronic empyaema deteriorates lung function and causes thoracic asymmetry due to intercostal narrowing in the diseased hemithorax. This study aims to investigate the rates of improvement in the pulmonary function tests (PFTs) and the thoracic deformity in late postoperative period of lung decortication, performed for chronic empyaema.


METHODS
A total of 50 patients who underwent standard open decortication for empyaema were included. The PFTs and computed tomographic (CT) scans of the chest were analysed in all patients after 6-58 months postoperatively. The measurements of antero-posterior and transverse diameters of both hemithoraxes were performed on both preoperative and postoperative chest CTs. The thoracic asymmetry was calculated as the ratio of the measurements of the diseased side to the normal side. The pre- and postoperative parameters were compared statistically.


RESULTS
The mean preoperative forced expiratory volume in first second (FEV(1)) and forced vital capacity (FVC) increased from 61.40% and 60.89% to 78.92% and 77.48%, respectively, in the late postoperative period (p<0.001). The mean preoperative transverse diameter of affected hemithorax increased from 11.22 cm to 11.98 cm (p<0.001) and, the transverse asymmetry improved from 11.52% to 5.94%, postoperatively (p<0.001). The mean preoperative antero-posterior chest diameter improved from 15.58 cm to 16.67 cm (p<0.001), and the antero-posterior asymmetry improved from 11.42% to 5.42% (p<0.001) in the late postoperative period.


CONCLUSIONS
The open decortication for chronic pleural empyaema significantly increases FEV(1) and FVC. Due to the re-expansion of the lung and enlargement of the intercostal spaces, the chest wall deformity also improves considerably after the operation.
Gokce
Mertol
M
Sureyyapasa Chest Diseases and Thoracic Surgery Teaching Hospital, Maltepe 34758, Istanbul, Turkey.
Okur
Erdal
E
Baysungur
Volkan
V
Ergene
Gokhan
G
Sevilgen
Gokcen
G
Halezeroglu
Semih
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003646:Debridement / Q000379:methods; D016724:Empyema, Pleural / Q000503:physiopathology / Q000601:surgery*; D004654:Empyema, Tuberculous / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D035441:Thoracic Wall / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014797:Vital Capacity; D055815:Young Adult