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Eur J Cardiothorac Surg 2002;21:502-507
© 2002 Elsevier Science NL

Decortication in chronic pleural empyema — effect on lung function

Witold Rzyman^a*, Jan Skokowski^a, Grzegorz Romanowicz^b, Piotr Lass^b, Rafa Dziadziuszko^c

^a Department of Thoracic Surgery, Medical University of Gdask, Gdask, Poland
^b Department of Nuclear Medicine, Medical University of Gdask, Gdask, Poland
^c Department of Oncology and Radiotherapy, Medical University of Gdask, Gdask, Poland

Received 15 August 2001; received in revised form 7 December 2001; accepted 17 December 2001.

* Corresponding author. Tel.: +48-58-3492400; fax: +48-58-3492429
e-mail: wrzyman{at}poczta.wp.pl

Objective: The aim of the present study is to evaluate the lung function before and after the lung decortication in patients with chronic pleural empyema (CPE). Methods: Twenty-six patients with diagnosis of CPE were evaluated in a prospective manner by lung perfusion scintigraphy, blood gas analysis and spirometry before and 35 weeks (±17) after the lung decortication. Results: Preoperative scintigraphy showed reduction of lung perfusion on the affected side to 24.5% (±12.6%) in 11 right side empyemas (predicted value 55%) and to 18% (±8%) in 15 left side empyemas (predicted value 45%). The postoperative measurements showed improvement in perfusion to 45.2% (±7.7%) in patients with right side empyema and 34.1% (±8.5%) with the left side affection. The preoperative vital capacity (VC) was reduced to 62.3% (±13.8%) of the predicted value and forced expiratory volume in 1 s (FEV1) to 50% (±15.5%) of the predicted value. Postoperatively, slight improvement was achieved to 79.8 % (±12.9%) for VC and 69.2% (±12.7%) for FEV1 . Blood gas analysis showed decreased values in majority of the patients before operation and significant improvement in postoperative evaluation. Conclusions: Perfusion and spirometry improves significantly in patients with CPE after the lung decortication but function of the affected lung remains impaired. There was no influence of the age, gender, side of the disease, bacteriology or duration of the empyema before operation on lung function.

Key Words: Chronic pleural empyema • Decortication • Lung function • Lung perfusion scintigraphy • Spirometry

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