Role of Anti-Tuberculous Treatment in the Outcome of Decortication for Chronic Tuberculous Empyema
| Autor: | Nazish Sikander, Ambreen Abid, Pratikshya Thapaliya, Nadir Ali, Tanveer Ahmad, Shagufta Nasreen, Misauq Mazcuri |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Tuberculous Empyema
medicine.medical_specialty Pulmonology medicine.medical_treatment Infectious Disease anti-tuberculous therapy 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine law medicine decortication Prospective cohort study business.industry General Engineering Decortication medicine.disease Intensive care unit air leak Surgery chronic tuberculous empyema Pneumothorax Cardiothoracic surgery Cardiac/Thoracic/Vascular Surgery lung expansion outcome Sputum medicine.symptom Complication business 030217 neurology & neurosurgery |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| Popis: | Introduction Chronic tuberculous empyema (CTE) is a common complication of tuberculosis that requires some form of surgical intervention along with anti-tuberculosis therapy (ATT). The aim of this study was to determine the optimum duration of pre-operative ATT in CTE prior to the decortication and its outcomes. Material and methods This comparative prospective study was conducted from August 2019 to August 2020 in the Department of Thoracic Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan. A total of 70 patients were included in the study. They were grouped into two arms: patients operated at or within six weeks of ATT commencement (Group A) and patients operated after six weeks of ATT (Group B). Both groups had 35 participants each. Patients were evaluated based on a self-administered questionnaire. A p-value of less than 0.05 was considered significant. Result In this study, there were 55 (78.6%) males and 15 (21.4%) females with a mean age of 33.5 ± 11.2 years. Diagnosis of CTE was most commonly made through sputum acid-fast bacilli (AFB) smear (n=35, 50%) which most commonly involved right upper (n=20, 28.6%) and lower lung lobes (n=20, 28.6%). Complications such as air leaks, need for ventilator support, need for intensive care unit (ICU) stay, residual collection, and pneumothorax all were significantly higher in Group A (31 patients out of 35) compared to Group B (18 patients out of 35). In Group B, 21 (60%) participants had full post-operative expansion of lungs, compared to eight (22.8%) in Group A (p=0.002). In total five participants had failure to expand lungs; all of them belonged to Group A (p=0.02). Conclusion The optimum timing of surgery and preoperative ATT is crucial for achieving better outcomes and requires good collaboration between the treating pulmonologist and thoracic surgeon. Our study highlights the importance of pre-operative ATT for at least more than six weeks before undertaking decortication for better outcomes and minimizing morbidity. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|