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Surgical decortication as the first-line treatment for pleural empyema

 Jung Ar Shin  ;  Yoon Soo Chang  ;  Tae Hoon Kim  ;  Seok Jin Haam  ;  Hyung Jung Kim  ;  Chul Min Ahn  ;  Min Kwang Byun 
 Journal of Thoracic and Cardiovascular Surgery, Vol.145(4) : 933-939, 2013 
Journal Title
 Journal of Thoracic and Cardiovascular Surgery 
Issue Date
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.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
김태훈(Kim, Tae Hoon) ORCID logo https://orcid.org/0000-0003-3598-2529
김형중(Kim, Hyung Jung) ORCID logo https://orcid.org/0000-0003-2498-0683
변민광(Byun, Min Kwang) ORCID logo https://orcid.org/0000-0003-1525-1745
신정아(Shin, Jung Ar)
안철민(Ahn, Chul Min)
장윤수(Chang, Yoon Soo)
함석진(Haam, Seok Jin)
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