Frequency of Failed Decortications in Post Tuberculous Empyema

Abstract

Objectives: Treatment of post-Tuberculous empyema remains challenge to clinicians. The objective of this study was to report frequency of failed decortications in post-tuberculous empyema.

Methodology: A cross-sectional observational study was carried out at Thoracoscopic Surgery Department of Lady Reading Hospital Peshawar. Medical records of hospital were reviewed retrospectively from last 5 years (from 2016-2021). Patients with post-tuberculous empyema that underwent decortication were included. Definition of empyema was taken as loculation or septations in pleural space identified on computed tomography. Patients without any decortications were excluded. SPSS was used for data analysis.

Results: From 110 patients, mean age 59.2 ± 19.4 years and 71 (65%) males and 39 (35%) females, mean BMI was 22.3±2.9 kg/m². All patients had history of pulmonary tuberculosis. Mean duration of symptoms before surgical treatment was 12.7 ± 9.8 days. 34 (31%) were successful while 76 (69%) decortications failed. Decortication as first line of treatment was used in 04 (12%) with successful decortications, while in 47 (62 %) with failed decortications (p<0.001). Mean duration of symptoms to treatment among successful decortications was 12.2 ± 9.5 days while in failed decortications 14.1 ± 10.2 days (p-0.06). Mean duration of hospital stay in successful decortications was 12.3 ± 7.7 days while in failed decortications 13.2 ± 8.1 days (p-0.08). Frequency of drainage fluid >1000 ml in successful decortications was 10 (29 %) while in failed decortications 52 (68 %). 11 (15 %) of patients died among failed decortications.

Conclusion: High frequencies of failed decortications due to post-tuberculous empyema were reported in this study.