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2010, Number 2

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Rev Med MD 2010; 1.2 (2)

Early thorascopic decortication as a treatment for pleural empyema in pediatrics. Experience of two years

Trujillo-Ponce SA, Aguirre-Jáuregui OM, Leal-Castillo R, Hernández D, Rodríguez-Franco E, Yanowsky-Reyes G

Language: Spanish
References: 21
Page: 57-61
PDF size: 541.95 Kb.


ABSTRACT

Background: Empyema is a collection of pus in pleural cavity resulting as a complication of pneumonia. Great benefits have been reported recently of removing adherences by thorascopic surgery in early stages of the disease (phase I and II).
Objective: To document results and advantages of early thorascopic surgery in pediatric patients in Fray Antonio Alcalde Hospital.
Methods: Descriptive, retrospective and observational study of patients in pediatric age admitted with the established diagnosis of pleural empyema in phases I and II, without any clinical or radiological signs of complication, summited to early thorascopic surgery in a two year period.
Results: Of a total of 428 cases, complicated pneumonia with pleural effusion was found in 14 patients, 5 of which were treated with open surgery. The other 9 patients were included in our study, 55% (5) of which were male, 44% (4) were female. Age groups were: newborn 44.5% (n=4), 29 days to a year of age 22.2% (n=2) 6 to 12 years 11.1% (n=1). Pleural tubes remained 3 days in 55% (5) of the cases and 5 days in 33.3% (3) of the cases. Only one post- surgery complication was documented (11.1%). Mean hospital stay was 8 days.
Conclusions: Early thorascopic decortication in pediatric patients with empyema reduces hospital stay, surgery time, reduces permanence of pleural tube, pulmonary re expansion and related complications. We suggest that a comparative double blind study comparing both techniques (open surgery vs thorascopic surgery) be conducted to effectively evaluate the usefulness of video assisted thorascopic surgery in the treatment (VATS) of pleural empyema.


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