VATS thoracoscopic decortication for empyema thoracic: A retrospective experience and analysis of 162 cases.

OBJECTIVE: To analyse the experience of empyema thoracis management using video-assisted thoracoscopic surgery. METHODS: The retrospective study was conducted at the Combined Military Hospitals, Rawalpindi and Lahore, Pakistan, and comprised data of empyema thoracis cases who underwent thoracoscopic decortications by the same consultant surgeon between January 2009 and 2018. Uniportal or multiportal video-assisted thoracoscopic decortications was performed. Histopathology and microbiological sampling were done in all cases. RESULTS: Of the 162 cases, 114(70.4%) were males and 48(29.6%) were females. The overall mean age was 44±16.37 years. Three ports were utilised in 58(36%) patients. Hospital stay of 122(75.3%) patients was <5 days post-procedure. Post-thoracotomy neuralgia occurred in 19(11.7%) patients, while 9(5.5%) had surgical site infection. Overall complications were 30(18.5%). There was no mortality. CONCLUSIONS: Video-assisted thoracoscopic decortications was found to be a safe, effective and efficient procedure.

Lung cancer in Pakistan, where do we stand?

Lung cancer is the most common cancer in males and second most common in females after breast cancer. We have compared our data with the international statistics to see where do we stand. In Pakistan, we do not have a valid central cancer registry at present which can provide a true picture of lung cancer. Therefore, we used statistics of GLOBOCON 2012, in order to evaluate the true burden of lung cancer in our population through the recently established data by PHRC (Pakistan Health and Research council). Our analysis showed that data depicting true incidence and mortality of lung cancer in Pakistan are lacking. GLOBOCON 2012 placed lung cancer as the 3rd most common cancer in Pakistan while PHRC 2016 placed it as the 10th most common cancer irrespective of the rise in smoking incidence in Pakistan over the past one decade. This calls for an urgent need to formulate a valid central cancer registry in the country in association with the local bodies.

Intralobar Pulmonary Sequestration With A Patent Bronchus; A Rare Presentation.

A 25 years male working as labourer in Middle East presented with episodic chest pain and productive cough for last 10 years. There was polycystic lesion in left lower chest cavity having separate arterial supply from descending aorta on radiology. It was diagnosed as intralobar sequestration. Operative findings confirmed the presence of separate blood supply from descending aorta and patent bronchial connection of intrapulmonary sequestration to the rest of the lung parenchyma. There are only few case reports in the literature describing this entity. Posterobasal segmentectomy was done with stapling of communicating bronchus.