INDICATIONS AND RESULTS OF PLEUROPULMONARY DECORTICATIONS IN THE UNIVERSITY HOSPITAL OF KINSHASA

In a retrospective and prospective study the authors assess factors in fluencing postoperative results in patients operated on for pachypleur itis with late referral to the hospital. There were 78 cases in the re trospective (1970-1984) and 28 cases in the prospective (1985-1992) pa rts of the study. The total number of treated cases is 106 (75 males a nd 31 females). There were 32 children (> 15 years of age) and 74 adul ts (less than or equal to 15 years). General condition was good in 45 patients (11 children and 34 adults) and poor in 61 patients (21 child ren and 40 adults). Ninety percent of the patients were operated on at least one month after the appearence of their symptoms. Eighty-one pa tients (75,4%) had an empyema secondary to bronchopulmonary infection (34 tuberculous). Other etiologies were : thoracic trauma: 23 cases (1 9 open and 4 internal); miscellaneous : 2 cases. The commonest isolate d organisms were S. aureus, (21,4%), Klebsiella (21,4%) Pseudomonas (1 3%), Proteus mirabilis, P. vulgaris, P. aeruginosa (11,9%), E. coli (8 ,4%) and Pyocyaneus (5,9%). In all cases, a total decortication was pe rformed. Good result was achieved in 55/106 (51,8%). There were 39/106 (36,9%) poor results and 12 operative deaths (11,3%). No correlation could be found between results and age, sex or etiology. A significant correlation appeared between duration of symptoms and postoperative r esults. The longer the delay; the worse the results.