About Decortication Empyema
Key Highlights
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Effectively eliminates chronic infection and pus from the chest cavity.Restores full lung expansion and significantly improves breathing capacity.Provides definitive treatment when antibiotics and simple drainage fail.Performed by experienced cardiac/thoracic surgeons for precise management of complex chest anatomy.Helps prevent long-term complications like permanent lung scarring and respiratory failure.
Who is this surgery for?
- Failed medical management of empyema with persistent infection despite antibiotics.
- Loculated or complex empyema where pus is trapped in multiple pockets, preventing effective drainage.
- Presence of a thick, fibrous pleural peel (cortex) seen on CT scan that is restricting lung movement.
- Chronic empyema lasting several weeks that has not resolved with chest tube thoracostomy.
- Development of a bronchopleural fistula (abnormal connection between lung airways and pleural space).
- To prevent permanent lung entrapment and progressive respiratory impairment.
How to prepare
- Comprehensive evaluation including chest X-ray, CT scan, and possibly ultrasound to map the extent of the empyema.
- Blood tests to assess infection levels, organ function, and clotting ability.
- Optimization of nutritional status, as chronic infection often leads to weight loss and weakness.
- Pre-operative physiotherapy to teach breathing exercises (incentive spirometry) for use after surgery.
- Discussion of anesthesia risks and a complete medical history review with the surgical and anesthesia team.
- Fasting for 6-8 hours before the scheduled surgery time.
Risks & possible complications
- Bleeding during or after the procedure, which may require transfusion.
- Infection at the surgical site or spread of infection.
- Air leak (persistent pneumothorax) from the lung surface after decortication.
- Reaccumulation of fluid or pus in the pleural space.
- Pain, which is common and managed with medications.
- Risks associated with general anesthesia and major surgery, such as blood clots, heart issues, or stroke.
- Injury to surrounding structures like nerves, blood vessels, or the diaphragm.
- Respiratory failure, especially in patients with pre-existing lung disease.
Recovery & hospital stay
- Initial recovery in the ICU or a high-dependency unit for close monitoring of breathing and vital signs.
- One or more chest tubes will remain in place for several days to drain fluid and air, allowing the lung to fully expand.
- Aggressive pain management is crucial to enable deep breathing and coughing exercises.
- Early mobilization with assistance to prevent blood clots and pneumonia.
- Continued breathing exercises with an incentive spirometer multiple times daily.
- Intravenous antibiotics will be continued post-operatively as prescribed.
- Follow-up appointments for wound check, chest X-ray, and removal of sutures/staples.
- Gradual return to normal activities over several weeks, avoiding heavy lifting for 6-8 weeks.
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Typical hospital stay: 7-14 days
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Expected recovery time: 4-8 weeks
Frequently Asked Questions
If you are considering decortication empyema in India, these questions and answers can help you make a confident, informed decision.
Popular choices for decortication empyema in India include Miot Hospital Chennai, Kamineni Hospital, King Koti, Kamineni Hospital, Tadigadapa, Manipal Hospital Old Airport Road, Manipal Hospital Bhubaneswar, known for experienced specialists and advanced surgical infrastructure.
Look at the doctor’s years of experience, hospital association, patient reviews, and how often they perform decortication empyema. MediFyr helps you compare cardiac surgeons and book consultations online.
The overall cost depends on hospital category, surgeon’s experience, room type, implant or device used (if any), length of stay, tests, and post-operative care. Our team can help you get cost estimates from multiple hospitals before you decide.
Procedure cost in other countries
Here is an overview of how the estimated cost, hospital stay, and recovery time for decortication empyema compare across other countries where we have data.
Top hospitals for Decortication Empyema in India
These partner hospitals in India have dedicated cardiac surgery teams and experience managing patients undergoing decortication empyema.
Krishna Khan, a 58-year-old former construction...
Krishna Khan, a 58-year-old former construction worker and father of three, had always been strong and active. A persistent cough and low-grade fever that started after a bout of pneumonia three weeks prior refused to go away. When he developed sharp, stabbing chest pain and became so short of breath he couldn't walk across his living room, his wife rushed him to the hospital. A CT scan revealed a large, complex pleural empyema, a walled-off pocket of infected pus in the space around his left lung, a severe complication of his pneumonia. His thoracic surgeon, Dr. Sharma, explained that antibiotics alone couldn't penetrate the thick rind of infected tissue. He recommended a decortication, a surgery to open the chest, drain the infection, and meticulously peel away the restrictive layer so Krishna's lung could re-expand. The surgery was long and complex. Afterward, attached to a chest tube and in significant pain, Krishna felt vulnerable and fearful that his strength was gone forever. The turning point came during pulmonary rehab. Each day, with immense effort and encouragement from his physiotherapist and family, he took deeper breaths. After two weeks, his chest tube was removed, and his lung was fully expanded on X-ray. The relief was profound. While his recovery required months of gradual rebuilding, the crushing chest pain and breathlessness were gone. Emotionally, he moved from a place of fear and frustration, feeling betrayed by his own body, to one of immense gratitude and a hard-won patience. He learned to measure progress in small victories and found a new appreciation for each deep, clear breath.
Cardiac surgeons for Decortication Empyema
Explore experienced cardiac surgeons who regularly perform decortication empyema and provide pre- and post-operative care in India.
- 31 Years Experience
- Pediatric Cardiac surgeon
Miot Hospital Chennai, Chennai
- 37 Years Experience
- Cardiac surgeon
Miot Hospital Chennai, Chennai
- 30 Years Experience
- Cardiac surgeon
Manipal Hospital Sarjapur Road, Bangalore
- 21 Years Experience
- Cardiac surgeon
Manipal Hospital Sarjapur Road, Bangalore
- 11 Years Experience
- Cardiac surgeon
Manipal Hospital Sarjapur Road, Bangalore
- 13 Years Experience
- Cardiac surgeon
- 31 Years Experience
- Cardiac surgeon
Manipal Hospital Whitefield, Bangalore
- 13 Years Experience
- Cardiac surgeon
Manipal Hospital Whitefield, Bangalore
- 15 Years Experience
- Cardiac surgeon
Manipal Hospital Old Airport Road, Bangalore
- 30 Years Experience
- Cardiac surgeon
Manipal Hospital Old Airport Road, Bangalore
- 16 Years Experience
- Cardiac surgeon
Manipal Hospital Old Airport Road, Bangalore
- 23 Years Experience
- Cardiac surgeon
Manipal Hospital Mysore, Mysore
- 13 Years Experience
- Cardiac surgeon
Manipal Hospital Vijayawada, vijayawada
- 23 Years Experience
- Cardiac surgeon
Manipal Hospital Malleshwaram, Bangalore
- 37 Years Experience
- Cardiac surgeon
SIMS Hospital Vadapalani, Chennai
- 8 Years Experience
- Cardiac surgeon
SIMS Hospital Vadapalani, Chennai
- 11 Years Experience
- Cardiac surgeon
SIMS Hospital Vadapalani, Chennai
- 17 Years Experience
- Cardiac surgeon
SIMS Hospital Vadapalani, Chennai
- 11 Years Experience
- Cardiac surgeon
Manipal Hospital Hebbal, Bangalore
- 15 Years Experience
- Cardiac surgeon
Manipal Hospital Hebbal, Bangalore