KẾT QUẢ PHẪU THUẬT BÓC VỎ MÀNG PHỔI ĐIỀU TRỊ MỦ MÀNG PHỔI GIAI ĐOẠN III TẠI BỆNH VIỆN ĐA KHOA TRUNG ƯƠNG CẦN THƠ

Abstract

Background: Stage III pleural empyema is a complex pathological condition characterized by a thick fibrous peel entrapping the lung parenchyma, leading to severe ventilatory restriction. Given that medical management and simple thoracentesis are typically ineffective, open thoracotomy decortication is an essential indication to clear the pleural space and liberate the lung parenchyma. Objectives: To describe the clinical and paraclinical characteristics and to evaluate the outcomes of open thoracotomy decortication in patients with stage III pleural empyema at Can Tho Central General Hospital 2024 - 2026. Materials and methods:  A prospective descriptive study was conducted on 38 patients diagnosed with stage III pleural empyema who met the indications for open thoracotomy decortication. Data regarding clinical presentations, paraclinical findings, and postoperative outcomes were collected and analyzed using SPSS version 25.0 software. Results: The clinical presentations included pleuritic chest pain 94.7%, fever 63.2%, cough 60.5%, and dyspnea 55.3%. Chest computed tomography scans revealed pleural thickening in 84.2% of cases and multiloculated pleural collections in 81.6%. The surgical success rate was 89.5%, with 94.4% of these patients demonstrating satisfactory lung re-expansion on postoperative chest radiographs. Conclusion: Open thoracotomy decortication is a highly effective therapeutic approach for stage III pleural empyema. It significantly improves clinical status, promotes optimal lung re-expansion on chest X-rays, and minimizes long-term complications for patients.