Safety and efficacy of medical thoracoscopy in the management of loculated thoracic empyema
Background: Pleural empyema can be subdivided into 3 stages: exudative, multiloculated, and organizing. In the absence of clear septation, antibiotics plus simple drainage of pleural fluid is often sufficient treatment, whereas clear septation often requires more invasive treatment. Aim of study: To...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2017-07-01
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| Series: | Egyptian Journal of Chest Disease and Tuberculosis |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S042276381630262X |
| _version_ | 1819070609009672192 |
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| author | Ahmed Hassan Ali Abo-El-maged Mohamed Fahmy Elsamadony Mousa Mohamed El-Shamly Wael Refaat Hablas |
| author_facet | Ahmed Hassan Ali Abo-El-maged Mohamed Fahmy Elsamadony Mousa Mohamed El-Shamly Wael Refaat Hablas |
| author_sort | Ahmed Hassan Ali Abo-El-maged |
| collection | DOAJ |
| description | Background: Pleural empyema can be subdivided into 3 stages: exudative, multiloculated, and organizing. In the absence of clear septation, antibiotics plus simple drainage of pleural fluid is often sufficient treatment, whereas clear septation often requires more invasive treatment.
Aim of study: To evaluate the safety and efficacy of medical thoracoscopy in the management of loculated thoracic empyema.
Methods: This study was conducted at chest department, Al-Azhar Faculty of medicine Al-Housein University Hospital in the period from October 2015 to August 2016. On 30 patients, 22 males and 8 females with age ranging between 20 and 74 years (mean age 48.3 ± 15.5 years). Diagnosed as loculated thoracic empyema (27 patients) or empyema failed to respond to medical treatment or chest tube drainage (3 patients) were undergo medical thoracoscopy.
Results: A total of 30 patients with loculated empyema were managed by medical thoracoscopy. Histopathological finding of study sample were (Non-specific inflammation 23.3%, Suppurative exudative reaction 16.7%, Tuberculous caseating granuloma 23.3%, Lymphocytic Inflammation 6.7%, fibrino purulent inflammation 13.3%, adenocarcinoma 3.3, Pleural fibrosis and thickening 10% and Pleural calcification, ossification, pleurisy 3.3%). Medical thoracoscopy was considered successful without further intervention in 26 of 30 patients (86.7%), 3 patients (10%) clinically improved but lung did not expanded and referred for thoracic surgery for decortication and 1 patient (3.3%) need for surgery to fistula closure.
Conclusions: Our study confirms that loculated pleural empyema could safely and successfully be treated by medical thoracoscopy. |
| first_indexed | 2024-12-21T17:08:39Z |
| format | Article |
| id | doaj.art-4c7d37d4cc9840c59164b2da641f836d |
| institution | Directory Open Access Journal |
| issn | 0422-7638 |
| language | English |
| last_indexed | 2024-12-21T17:08:39Z |
| publishDate | 2017-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Egyptian Journal of Chest Disease and Tuberculosis |
| spelling | doaj.art-4c7d37d4cc9840c59164b2da641f836d2022-12-21T18:56:27ZengWolters Kluwer Medknow PublicationsEgyptian Journal of Chest Disease and Tuberculosis0422-76382017-07-0166344545110.1016/j.ejcdt.2016.12.013Safety and efficacy of medical thoracoscopy in the management of loculated thoracic empyemaAhmed Hassan Ali Abo-El-maged0Mohamed Fahmy Elsamadony1Mousa Mohamed El-Shamly2Wael Refaat Hablas3Department of Chest Diseases, Faquse General Hospital, Ministry of Health, EgyptDepartment of Chest Diseases, Faculty of Medicine, Al-Azhar University, EgyptDepartment of Chest Diseases, Faculty of Medicine, Al-Azhar University, EgyptDepartment of Clinical Pathology, Faculty of Medicine, Al-Azhar University, EgyptBackground: Pleural empyema can be subdivided into 3 stages: exudative, multiloculated, and organizing. In the absence of clear septation, antibiotics plus simple drainage of pleural fluid is often sufficient treatment, whereas clear septation often requires more invasive treatment. Aim of study: To evaluate the safety and efficacy of medical thoracoscopy in the management of loculated thoracic empyema. Methods: This study was conducted at chest department, Al-Azhar Faculty of medicine Al-Housein University Hospital in the period from October 2015 to August 2016. On 30 patients, 22 males and 8 females with age ranging between 20 and 74 years (mean age 48.3 ± 15.5 years). Diagnosed as loculated thoracic empyema (27 patients) or empyema failed to respond to medical treatment or chest tube drainage (3 patients) were undergo medical thoracoscopy. Results: A total of 30 patients with loculated empyema were managed by medical thoracoscopy. Histopathological finding of study sample were (Non-specific inflammation 23.3%, Suppurative exudative reaction 16.7%, Tuberculous caseating granuloma 23.3%, Lymphocytic Inflammation 6.7%, fibrino purulent inflammation 13.3%, adenocarcinoma 3.3, Pleural fibrosis and thickening 10% and Pleural calcification, ossification, pleurisy 3.3%). Medical thoracoscopy was considered successful without further intervention in 26 of 30 patients (86.7%), 3 patients (10%) clinically improved but lung did not expanded and referred for thoracic surgery for decortication and 1 patient (3.3%) need for surgery to fistula closure. Conclusions: Our study confirms that loculated pleural empyema could safely and successfully be treated by medical thoracoscopy.http://www.sciencedirect.com/science/article/pii/S042276381630262X |
| spellingShingle | Ahmed Hassan Ali Abo-El-maged Mohamed Fahmy Elsamadony Mousa Mohamed El-Shamly Wael Refaat Hablas Safety and efficacy of medical thoracoscopy in the management of loculated thoracic empyema Egyptian Journal of Chest Disease and Tuberculosis |
| title | Safety and efficacy of medical thoracoscopy in the management of loculated thoracic empyema |
| title_full | Safety and efficacy of medical thoracoscopy in the management of loculated thoracic empyema |
| title_fullStr | Safety and efficacy of medical thoracoscopy in the management of loculated thoracic empyema |
| title_full_unstemmed | Safety and efficacy of medical thoracoscopy in the management of loculated thoracic empyema |
| title_short | Safety and efficacy of medical thoracoscopy in the management of loculated thoracic empyema |
| title_sort | safety and efficacy of medical thoracoscopy in the management of loculated thoracic empyema |
| url | http://www.sciencedirect.com/science/article/pii/S042276381630262X |
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