Decortication in Adult Patients – Experience of 650 Cases via Thoracotomy

Abstract

Background: Chronic empyema and fibrothorax are debilitating conditions that severely restrict lung expansion, cause persistent infection, and impair quality of life. When medical therapy and repeated drainage fail, surgical decortication is often the only option to restore pulmonary function. Objective: This study aimed to evaluate the outcomes of decortication in adult patients, with particular focus on lung re-expansion, symptom relief, complications, and survival. Method: A descriptive observational study was conducted on 650 adult patients who underwent decortication for chronic empyema or fibrothorax. Data were collected on demographics, etiology of the disease, clinical presentation, operative findings, postoperative complications, and outcomes. Result: A total of 650 cases of decortication were performed via thoracotomy. The predominant etiology was parapneumonic empyema (86%), followed by tuberculous empyema (12%) and others (2%). Adequate lung expansion was achieved in 98% of patients. Postoperative complications included prolonged air leak in 4.5% and wound infection in 1.8%. The overall mortality was 2%. Conclusion: Decortication via thoracotomy in adults remains a safe and effective procedure. With parapneumonic empyema as the predominant etiology, this large series shows excellent outcomes, including 98% lung re-expansion, low complication rates, and 2% mortality.

Keywords: Decortication, Empyema, Fibrothorax, Thoracic Surgery, Adult Patients.