Rizwan Aziz Memon, Syed Ali Arsalan, Ali Raza Uraizee, Jawed Ahmed Memon, Aneel Roy Bhagwani, Imroz Arif Farhan.
Tuberculous empyema thoracic -surgical perspective.
J Bahria Uni Med Dental Coll Jan ;4(1):12-5.

Objective: To find out the difference in outcome of patients undergoing surgery for tuberculous empyema in early V/S late stages of disease. Subjects and Methods: This is a retrospective study of 163 patients of 20-50 years of age who underwent thoracotomy and decortication for tuberculous empyema thoracic from July 2009 to June 2013. Patients were divided into two groups on the basis of their duration of use of Anti-Tuberculosis Therapy (ATT). Group A (n=80) took ATT for 2 months and Group B (n=83) took ATT for 4 months and above. Age less than 20yrs and above 50yrs, poor functional and nutritional status, underlying parenchymal disease, A.T.T. Defaulters and MDR T.B were excluded. Results: There was no mortality in Group A, while 1 mortality occurred in Group B. Mean day of discharge was 5th post-operative day in Group A and 6th in Group B. 7 patients from Group A and 13 patients from Group B had wound complications whereas 5 patients from Group A and 12 from Group B required up to 10 day of hospitalization due to prolonged air leaks. 1 patient from Group B required revision of procedure and ended up with pleurocutaneous window. Conclusion: Operating patients early with T.B Empyema Thoracic carries better results if compared to those operated at a later stage. Patient selection is an important factor. Key to success is adequate intake of A.T.T. dose by the patients

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