ABSTRACT
A review of 114 thoracic empyema cases attended in the thoracic unit of the Muhimbili Medical Centre from July 1986 to July 1990 is presented. 87.7% of the cases were males. Their ages ranged from 9 to 79 years with a mean of 32 years. Tuberculosis was the major cause accounting for 63.2% of all the cases. 53.4% of the patients underwent either open chest drainage decortication or thoracoplasty. The duration of hospital stay ranged from 2-8 months with a mode around 3.5 months. A 7% mortality was noted.
Subject(s)
Empyema, Pleural/epidemiology , Adolescent , Adult , Age Factors , Chest Tubes/statistics & numerical data , Child , Drainage/statistics & numerical data , Empyema, Pleural/etiology , Empyema, Pleural/mortality , Empyema, Tuberculous/epidemiology , Empyema, Tuberculous/mortality , Female , Humans , Length of Stay/statistics & numerical data , Male , Middle Aged , Sex Factors , Tanzania/epidemiology , Thoracoplasty/statistics & numerical data , Thoracostomy/statistics & numerical data , Treatment OutcomeABSTRACT
The operative results in a series of 17 patients with pyothorax were reviewed. Of these, 10 had chronic empyema (group 1), and 7 had postoperative empyema (group 2). A single-stage operation was performed in eight patients in group 1 (decortication in six, thoracoplasty in one, omental plombage in one) and in all patients in group 2 (omentopexy in five, thoracoplasty in two). Two-stage procedures were performed in two patients in group 1. We obtained favorable postoperative results in eight patients in group 1, and in four patients in group 2. In our series, good results were not obtained by thoracoplasty alone; however, satisfactory results were achieved by short-term management in patients treated with the omental method. We think this series demonstrates the value of the omental pedicle flap method, which prevents loss of function due to a defective organ and offers excellent therapeutic results following an easy operative procedure. Further active application of this method can be expected in the management of thoracic disorders.
Subject(s)
Empyema, Pleural/surgery , Omentum/surgery , Surgical Flaps/methods , Adult , Aged , Bronchial Fistula/complications , Bronchial Fistula/surgery , Empyema, Pleural/complications , Empyema, Pleural/mortality , Empyema, Tuberculous/mortality , Empyema, Tuberculous/surgery , Evaluation Studies as Topic , Female , Fistula/complications , Fistula/surgery , Humans , Male , Middle Aged , Pleural Diseases/complications , Pleural Diseases/surgery , Surgical Flaps/mortalityABSTRACT
The pleural empyema, e.g. postpneumonial or postoperative, has, in an acute state of being, to be treated before all by an aimed intensive puncture, irrigation, and drainage therapy. Removing the cause of the empyema you can expect a cure as a rule, but in certain cases an operative intervention is still necessary. The chronic empyema often needs a decortication for an operative correction. The trials of medical treatment being often conservative and the chronic intoxication most often cause a strong impairment of the general condition. A lot of other organic affections or damages reduce the chances of cure and increase lethality. The chronic empyema not available for an operative correction has, as a whole, a bad long-term prognosis with a high morbidality and lethality. The qualities of living of these patients are often reduced a lot.
