Role of Partial Thoracoplasty in Lung Lesions —A Single Institute Experience

Abstract

Thoracoplasty has been a useful procedure to control and cure recalcitrant lung lesions often as a last measure to treat pulmonary infections like post- tubercular chronic empyema with fibrocavitary lesions and residual pleural space infections after pulmonary resections. Long-standing empyemas with persistent discharge on drainage often respond poorly after decortication and debridement alone due to non-expanding underlying lung tissue due to fibrotic changes. These cases often develop recurrent empyemas with sepsis with high morbidity and mortality. Similarly chronic space-occupying lung lesions with adjacent pulmonary damage and fibrosis leave a considerable residual space after surgery of these lesions and these persistent residual space leads to pleural space infections and empyema. In the presence of a large apical abscess and destruction of the apical pulmonary tissue forming a potential space confined by the bony thoracic cage and limited inferiorly by the rigid lining of the abscess, the cure and management of the chronic empyema especially the post-tubercular ones are particularly difficult. We address these cases in our series by performing partial thoracoplasty tailored to the site of the lesions in addition to other procedures. Partial thoracoplasty was found beneficial for selective cases of chronic empyema, obliteration of residual cavity after resectional surgery and management of the apical abscess.