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Surgical decortication as the first-line treatment for pleural empyema

Authors
 Jung Ar Shin  ;  Yoon Soo Chang  ;  Tae Hoon Kim  ;  Seok Jin Haam  ;  Hyung Jung Kim  ;  Chul Min Ahn  ;  Min Kwang Byun 
Citation
 Journal of Thoracic and Cardiovascular Surgery, Vol.145(4) : 933-939, 2013 
Journal Title
 Journal of Thoracic and Cardiovascular Surgery 
ISSN
 0022-5223 
Issue Date
2013
Abstract
OBJECTIVE: The study objective was to evaluate the clinical outcomes of surgical decortication as the first line of treatment for pleural empyema. METHODS: We analyzed the medical records of 111 patients who presented with empyema and were treated with simple drainage or surgical decortication as the first line of treatment at Gangnam Severance Hospital, a tertiary referral medical center in Seoul, Korea. RESULTS: Of 111 patients with empyema, 27 underwent surgical decortication as the first intervention. Surgical decortication showed a better treatment success rate in all study subjects (96.3%, 26/27 patients) compared with simple drainage (58.3%, 49/84 patients; P < .0001 for method comparison). After propensity-scored matching, decortication resulted in a better outcome (95.0%, 19/20 patients) versus drainage (56.7%, 17/30 patients; P = .003). Surgical decortication as the first line of treatment for empyema was the best predictor of treatment success after adjustment for compounding factors (odds ratio, 14.529; 95% confidence interval, 1.715-123.074; P = .014). CONCLUSIONS: The first treatment choice for pleural empyema is a critical determinant of ultimate therapeutic success. After adjusting for confounding variables, surgical decortication is the optimal first treatment choice for advanced empyema.
Full Text
http://www.sciencedirect.com/science/article/pii/S0022522312008781
DOI
10.1016/j.jtcvs.2012.07.035
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-3598-2529
Kim, Hyung Jung(김형중) ORCID logo https://orcid.org/0000-0003-2498-0683
Byun, Min Kwang(변민광) ORCID logo https://orcid.org/0000-0003-1525-1745
Shin, Jung Ar(신정아)
Ahn, Chul Min(안철민)
Chang, Yoon Soo(장윤수) ORCID logo https://orcid.org/0000-0003-3340-4223
Haam, Seok Jin(함석진)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86565
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