PLEURO-CUTANEOUS WINDOW IN MANAGEMENT OF CHRONIC EMPYEMA- A SINGLE CENTER STUDY

Abstract

Background: Various treatment options are available for the management of empyema including medical therapy, open and closed drainage, decortication and thoracoplasty. Pleuro-cutaneous window (PC window) is an accepted method of treatment for optimal drainage of chronic empyemas. Open window thoracostomy should be considered in debilitated patients with empyema, where denitive surgery is not indicated and failure to control the disease by tube thoracostomy. Materials and Method: This was a single center study, conducted on 60 patients of chronic empyema at Institute of Respiratory Diseases during January 2016 to December 2020. These patients were initially treated with medical therapy and chest tube drainage but their lungs were not completely expanded. They were not the candidates for denitive surgery at that time because of their medical and lungs condition, hence they were treated by pleura-cutaneous window. Results: Mean age of patients in our study was 35.63 ± 12.14 years and age range was 15 to 60 years. In our study 49 patients were male and 11 were females. Patients with left sided empyema were 34 (56.67%) and with right sided empyema were 26 (43.33%). Most of the patients 44 (73.33%) had chest tube drainage for 3 to 4 months. Average duration of hospital stay was 7 days. Lung expansion occurred in 32 (53.33%) patients. Conclusion: Open drainage by pleuro-cutaneous window expands the entrapped lungs despite the presence of broncho-pleural stulas. Pleuro-cutaneous window also has psychological benets in these patients