THORACOPLASTY, AN EXPERIENCE OF 513 CASES OVER 12 YEARS PERIOD IN A DEVELOPING COUNTRY

Abstract

OBJECTIVE: To assess that thoracoplasty is not an obsolete procedure, and isstill a useful space obliterating collapse procedure.MATERIAL AND METHODS: This retrospective observational study was conductedin Thoracic surgery unit Lady Reading Hospital, Peshawar from Jan2003 to Nov 2014. Patients who had thoracoplasty done as a collapse therapyin these 12 years were included in this study. Total number of patients whounderwent this procedure were 513. Patients who had other space obliterationprocedures like muscle interposition, pleural tenting, were excluded from thestudy. The demographic data, operative findings, out come of procedure interms of postoperative complications, 30 day mortality and duration of ICU andhospital stay were recorded from the data base of patients record of the ward.RESULTS: Our study included 360 male and 153 female patients, age rangesfrom 12 years to 70 years (Mean age 31 years) out of 513 patients310 had completethoracoplasty, while 203 had patrtial thoracoplasty.In 490 patients thracoplastywas done as a space obliterating collapse therapy, while in 23 patientspatients were not fit for resectional surgery and having heamptasis or MDR TB.Mobidity was 29 (5.65%) patients, three patients had complete break down ofwound, 17 patients had wound infection, 2 patients with partial thoracoplastywere re-opened to do complete thoracoplasty and 7 patients had persistingsinus. Mortality was 11 (2.14%), three patients did not recover from anesthesia,and 8 of them had persistent sepsis, septicemia and cachexia. Mean ICU staywas 2 days and mean hospital stay was 5 days.CONCLUSION: There is still a role for this obsolete procedure in selected casesof persistent infected pleural space, with little or no viable lung tissue.