Abstract | OBJECTIVE: To evaluate the results of thoracoscopy for the treatment of pleural empyema in pediatric patients. METHODS: A retrospective study of 117 patients who underwent mediastinoscopy or video-assisted thoracoscopy for pleural empyema treatment. General anesthesia and single-lumen oral intubation were used. Surgery was indicated when there was pleural effusion and no clinical and radiological response to clinical treatment ( antibiotics, physiotherapy and thoracocentesis) or severe sepsis, together with loculated pleural effusion (confirmed through ultrasound or computed tomography of the chest). RESULTS: Between February of 1983 and July of 2006, 117 thoracoscopies were performed in patients ranging in age from 5 months to 17 years (mean, 4 years). Mean time for thoracic drainage was 9 days (range, 2-33 days), and mean period of hospitalization was 16.4 days (range, 4 to 49 days). One patient (0.8%) died after surgery, and persistent fistula was observed in 33 patients (28%). In 7 cases (6%), open thoracotomy with pulmonary decortication was performed due to the disposition of the empyema. CONCLUSIONS: Management of pleural empyema in this age bracket is still controversial, and surgical indication is often delayed, particularly when there are multiple loculations or severe sepsis. Early thoracoscopy yields a better clinical outcome for pediatric patients with pleural empyema, with apparent decreased morbidity and mortality, earlier chest tube removal, earlier hospital discharge and improved response to antibiotic therapy.
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Authors | Davi Wen Wei Kang, José Ribas Milanez de Campos, Laert de Oliveira Andrade Filho, Fabiano Cataldi Engel, Alexandre Martins Xavier, Maurício Macedo, Karine Meyer |
Journal | Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia
(J Bras Pneumol)
Vol. 34
Issue 4
Pg. 205-11
(Apr 2008)
ISSN: 1806-3756 [Electronic] Brazil |
PMID | 18425256
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Adolescent
- Child
- Child, Preschool
- Empyema, Pleural
(surgery)
- Female
- Humans
- Infant
- Length of Stay
- Male
- Thoracoscopy
(methods)
- Treatment Outcome
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