The role of thoracoscopy in the treatment of pleural empyema in children |
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Authors: | J Dzielicki W Korlacki |
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Institution: | (1) Department of Pediatric Surgery, Medical University of Silesia, 3 Maja 13-15, Zabrze, 41-800, Poland;(2) Minimally Invasive Surgery Center for Adults and Children, University Hospital No. 1, Zabrze, Poland |
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Abstract: | Background The treatment of empyema with pleural drainage is a widely accepted surgical procedure. Currently, thoracoscopy often is used
to treat this disease in some thoracic surgery centers. This report aims to present the authors’ experience with the treatment
of pleural empyema and the benefits of thoracoscopy.
Methods From 1997 to 2005, 49 children with a diagnosis of pleural empyema were treated by means of thoracoscopy in the authors’ department.
The study group consisted of 21 girls and 28 boys, ages 1 to 17 years (mean age, 9.2 years). Thoracoscopic cleaning and drainage
of the pleural cavity was performed for all the patients.
Results Intraoperatively, stage I empyema was recognized in 7 children (14.3%), stage II in 30 children (61.2%), and stage III in
12 children (24.5%). Very good results were obtained for all the patients. There were no intra- or postoperative major complications.
The drainage time was less than 5 days for 63.3% of the children. In the remaining group of patients, drainage exceeded 8
days only for 16.3%. The postoperative time was short. Emptying of the pleural cavity and full lung decompression were achieved
in all cases. In four cases, pleural biopsy showed TB, which enabled early proper treatment.
Conclusions Thoracoscopy can offer good visualization and cleansing of the empyema chambers, establishing efficient drainage even for
patients with advanced stages of pleural empyema. Thoracoscopy enables collection of material not only for bacteriologic,
but also for histopathologic examination. The method is minimally invasive, and risk for complication is comparable with that
for classical thorax drainage. |
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Keywords: | Pleural drainage Pleural empyema Thoracoscopy Thorax drainage |
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