Indications and results of pleuropulmonary decortications in the university hospital of Kinshasa.
In a retrospective and prospective study the authors assess factors influencing postoperative results in patients operated on for pachypleuritis with late referral to the hospital. There were 78 cases in the retrospective (1970-1984) and 28 cases in the prospective (1985-1992) parts of the study. The total number of treated cases is 106 (75 males and 31 females). There were 32 children (> 15 years of age) and 74 adults (< or = 15 years). General condition was good in 45 patients (11 children and 34 adults) and poor in 61 patients (21 children and 40 adults). Ninety percent of the patients were operated on at least one month after the appearance of their symptoms. Eighty-one patients (75.4%) had an empyema secondary to bronchopulmonary infection (34 tuberculous). Other etiologies were: thoracic trauma: 23 cases (19 open and 4 internal); miscellaneous: 2 cases. The commonest isolated organisms were S. aureus, (21.4%), Klebsiella (21.4%) Pseudomonas (13%), Proteus mirabilis, P. vulgaris, P. aeruginosa (11.9%), E. coli (8.4%) and Pyocyaneus (5.9%). In all cases, a total decortication was performed. 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 results. The longer the delay; the worse the results.