HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Gilbert Massard Jean-Marie Wihlm Norbert Roeslin Georges Morand Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Massard, G. Articles by Morand, G. Search for Related Content PubMed PubMed Citation Articles by Massard, G. Articles by Morand, G.

Ann Thorac Surg 1995;60:888-895
© 1995 The Society of Thoracic Surgeons

---

Original Articles: General Thoracic

Decortication Is a Valuable Option for Late Empyema After Collapse Therapy

Department of Thoracic Surgery, University Hospital of Strasbourg, Strasbourg, France

Background. Infection of previous collapse therapy spaces may raise challenging problems. This study evaluated a conservative surgical approach based on decortication.

Methods. Since 1979, 28 patients (mean age, 60 ± 6 years) have presented at an average of 37 ± 7 years after artificial pneumothorax for tuberculosis. Diagnosis of empyema was made on follow-up in 12 patients and on symptoms in 16 patients. Mean vital capacity was 66% ± 16% of normal. Microorganisms were isolated in 13 patients (Aspergillus fumigatus in 5, Mycobacterium tuberculosis in 4, anaerobes in 4). Decortication was made in 24 patients, associated with thoracoplasty in 4, and with partial lung resection in 2 patients. Thoracoplasty alone was performed in 2 patients, and 2 patients underwent an extrapleural pneumonectomy.

Results. Both extrapleural pneumonectomies were complicated with empyema requiring thoracoplasty, resulting in one postoperative death. Operative mortality after decortication was nil. Mean intraoperative blood loss during decortication was 1,830 ± 1,310 mL. All patients were extubated within 24 hours, except 1 patient who was ventilator-dependent preoperatively. Prolonged air leaks were common (mean duration of drainage, 16 ± 11 days), but ultimately sealed. Existence of symptoms was predictive of prolonged air leaks (p < 0.01).

Conclusions. We conclude that decortication may provide a one-stage cure avoiding the hazards of extrapleural pneumonectomy; the nonfunctioning remaining lung may resolve the space problem.

This article has been cited by other articles:

				Y. T. Kim, H. K. Kim, S.-W. Sung, and J. H. Kim Long-term outcomes and risk factor analysis after pneumonectomy for active and sequela forms of pulmonary tuberculosis Eur. J. Cardiothorac. Surg., May 1, 2003; 23(5): 833 - 839. [Abstract] [Full Text] [PDF]

				Y. Shiraishi, Y. Nakajima, A. Koyama, K. Takasuna, N. Katsuragi, and S. Yoshida Morbidity and mortality after 94 extrapleural pneumonectomies for empyema Ann. Thorac. Surg., October 1, 2000; 70(4): 1202 - 1206. [Abstract] [Full Text] [PDF]

				K. M. Al-Kattan Management of tuberculous empyema Eur. J. Cardiothorac. Surg., March 1, 2000; 17(3): 251 - 254. [Abstract] [Full Text] [PDF]

				A. Chatzimichalis, G. Massard, R. Kessler, P. Barsotti, B. Claudon, J. Ojard-Chillet, and J.-M. Wihlm Bronchopulmonary Aspergilloma: A Reappraisal Ann. Thorac. Surg., April 1, 1998; 65(4): 927 - 929. [Abstract] [Full Text] [PDF]

				G. Massard, P. Thomas, P. Barsotti, P. Riera, R. Giudicelli, E. Reboud, G. Morand, P. A. Fuentes, and J.-M. Wihlm Long-Term Complications of Extraperiosteal Plombage Ann. Thorac. Surg., July 1, 1997; 64(1): 220 - 225. [Abstract] [Full Text]

				G. Massard, A. Dabbagh, J.-M. Wihlm, R. Kessler, P. Barsotti, N. Roeslin, and G. Morand Pneumonectomy for Chronic Infection Is a High-Risk Procedure Ann. Thorac. Surg., October 1, 1996; 62(4): 1033 - 1037. [Abstract] [Full Text]