Is there a place for thoracoscopic debridement in the treatment of empyema in children?

Details

Serval ID
serval:BIB_844C2B93182D
Type
Article: article from journal or magazin.
Collection
Publications
Title
Is there a place for thoracoscopic debridement in the treatment of empyema in children?
Journal
European Journal of Pediatric Surgery
Author(s)
Tönz M., Ris H.B., Casaulta C., Kaiser G.
ISSN
0939-7248
Publication state
Published
Issued date
2000
Peer-reviewed
Oui
Volume
10
Number
2
Pages
88-91
Language
english
Abstract
BACKGROUND: Video-assisted thoracoscopic debridement has been shown to be a safe and efficient procedure for empyema in the adult patient. Its place in the management of childhood empyema remains controversial. METHODS: Over an 18-month period, 9 children were operated upon for pleural empyema. All children were initially treated with appropriate antibiotics and chest-tube drainage. Indication for surgery were persistent clinical symptoms and loculation of pleural fluid 5 to 7 days following initial treatment. In case of a duration of the illness of less than 14 days, an initial attempt was made to debride the pleural space by thoracoscopy. RESULTS: Mean duration of the illness prior to surgery was 15 days (range: 10-23 days), and mean duration of preoperative conservative treatment 10 days (range: 5-20 days). In five of the nine patients thoracoscopy was performed. In all patients thoracoscopy failed to provide adequate clearance of the diseased pleural space because of the advanced stage of the disease. The procedure was converted to a formal thoracotomy in four patients, the fifth patient continued to deteriorate and required formal thoracotomy and decortication seven days later. CONCLUSION: This limited experience suggests that, with the current management and indications, video-assisted thoracoscopic surgery adds little benefit to the treatment of childhood empyema.
Keywords
Adolescent, Child, Child, Preschool, Debridement, Empyema, Pleural, Female, Humans, Infant, Male, Thoracic Surgery, Video-Assisted
Pubmed
Web of science
Create date
29/01/2008 14:00
Last modification date
03/03/2018 18:54
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