Minimally Invasive Lateral Thoracotomy (MILT) and Decortication: A Prospective Study on Chronic Organised Empyema and its Outcome
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 5
Abstract
Introduction: Chronic empyema is prevalent worldwide. Technique of needle aspiration, intercostal drainage tube insertion works in early stage. Decortication and open drainage are required for late stage of empyema. Treatment and approach to the disease to be decided on the basis of stages of empyema and status of the lung. Complex advanced nature of chronic organised empyema does not permits to use Video Assisted Thoracoscopic Surgery(VATS) as first line of approach, so instead use open classical posteriolateral thoracotomy and Decortication. Study objectives were to evaluate outcome of minimally invasive lateral thoracotomy (MILT) and decortication as an alternative approach to overcome the short comings of posteriolateral thoracotomy and VATS. Material and methods: We studied fifty patients, suffering from chronic empyema due to various causes. All had undergone lateral thoracotomy with minimal incision of 3 inches length and Decortication. Subsequently cases evaluated for duration of surgery, complete lung expansion, post operative complication. Result: Minimally invasive lateral thoracotomy (MILT) evidently allows successful complete Decortication and full lung expansion in the majority of cases. It reduced the amount of pain with minimum acceptable complication. Helped to reduce Stay in the hospital and minimised total cost of treatment. Conclusion: Minimally invasive lateral thoracotomy (MILT) approach can be used alternate to VATS instead of conventional posteriolateral thoracotomy. One can reap more or less all advantages of VATS at lesser cost with need of lesser learning curve to do Decortication.
Authors and Affiliations
Arun Kumar Haridas, Bharathi Shridhar Bhat
Keywords
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