Volume : 7, Issue : 5, May - 2018

Quadrangular Eloesser Flap versus Classical rib resection & open drainage technique: A prospective randomised study of chronic organised empyema and its outcome

Dr. Arun Kumar Haridas, Dr. Bharathi Shridhar Bhat

Abstract :

<p class="MsoNormal"><span lang="EN-IN">Back ground </span></p> <p class="MsoNormal"><span lang="EN-IN">Chronic organised empyema, due to tuberculosis, still pandemic in developing countries. It is more difficult to cure due to complexity of disease and stages. Technique of needle aspiration of pus, intercostal drainage tube insertion works in early stage. Decortication, rib resection and open drainage, Eloesser Flap and Thoracoplasty are required for late stage, hence the treatment to be decided on the basis of stages of chronic empyema and status of the underlying functioning lung.<span style="mso-spacerun:yes">&nbsp; </span></span></p> <p class="MsoNormal"><span lang="EN-IN">Objective</span></p> <p class="MsoNormal"><span lang="EN-IN">To compare and evaluate outcome of classical rib resection and open drainage versus quadrangular Eloesser Flap technique, in chronic organised empyema patients.</span></p> <p class="MsoNormal"><span lang="EN-IN"><o:p>&nbsp;</o:p></span></p> <p class="MsoNormal"><span lang="EN-IN">Method </span></p> <p class="MsoNormal"><span lang="EN-IN">We studied 100 patients, suffering from chronic organised empyema. Divided them in, 50 each group randomly and treated them with two different surgical techniques. Classical rib resection and open drainage done in group A and ours new technique quadrangular Elloesser Flap technique used for group B. Procedures done only in patient who had fixed mediastinum.</span></p> <p class="MsoNormal"><span lang="EN-IN">Result </span></p> <p class="MsoNormal"><span lang="EN-IN">Majority were suffering from tubercular organised empyema. Quadrangular Eloesser Flap had greater advantage in survivality, early mobilization, reduction in sepsis, easy to manage wound, longer patency of fistula and higher lung expansion.</span></p> <p class="MsoNormal"><span lang="EN-IN">Conclusion</span></p> <p class="MsoNormal"><span lang="EN-IN">Quadrangular Eloesser Flap technique is far superior than contemporary techniques. It should be primary modality of treatment in organised chronic tubercular empyema with fixed mediastinum and or underlying diseased lung.</span></p>