DEAD SPACE REDUCTION CLOSED THORACOPLASTY IN CHRONIC EMPYEMA THORACIS PATIENTS OF EARLY YOUNG AGE GROUP
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 14
Abstract
BACKGROUND The social stigma of chronic empyema thoracis treated with open window thoracostomy (OWT) has significant negative impact on psychosocial well-being, especially in early young age group patients. So, evaluation of better alternative of dead space reduction closed thoracoplasty method was done by the author. Aims and Objectives- To evaluate standard easily reproducible surgical method to cure and control chronic empyema thoracis other than open window thoracostomy in early young age group patients in central India. MATERIALS AND METHODS Dead space reduction closed thoracoplasty was performed in 44 patients of chronic empyema thoracis between the age group of 13 and 25 years by conventional thoracoplasty (Alexander type), tailoring thoracoplasty and Schede thoracoplasty. Patients were evaluated in terms of weight gain, chest x-ray, air leak and column movement in ICD and pus culture sensitivity at regular intervals. Targeted dead space reduction is achieved excellently when column movement is less than 5 cm and acceptable when between 5 and 10 cm. Absence of air leak even on coughing (excellent) and only on coughing (acceptable) in patent intercostal drainage tube. Statistical Analysis- By student’s t-test, repeated measure ANOVA test for difference of mean, confidence interval with standard error estimation, ‘p’ value and percentage also. Setting and Design- A hospital-based prospective longitudinal study as all the enrolled patients are followed up at designed time. RESULTS Chronic empyema thoracis of 40 patients was cured and controlled with dead space reduction thoracoplasty, whereas 4 patients with multi-drug resistance tuberculosis (MDR TB) did not cure, so they further required other modalities. CONCLUSION Patients with persistent infection and poor weight gain have high failure rate in dead space reduction closed thoracoplasty
Authors and Affiliations
Praveen Sharma, Deepesh Gupta, Kaushal R. P, Ankur Joshi
Keywords
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- EP ID EP414387
- DOI 10.14260/jemds/2018/400
- Views 93
- Downloads 0
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