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Thoracoscopic debridement for acute pediatric empyema: efficacy of ultrasonic surgical device
H Nakamura1, Y Taniguchi, K Makihara
1Second Department of Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan.
Insights
Thoracoscopic debridement offers a minimally invasive option for treating pediatric empyema. This technique, utilizing ultrasonic devices, effectively clears infections and may prevent the need for open surgery.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Minimally Invasive Procedures
Background:
- Pediatric empyema is a significant thoracic infection.
- Limited research exists on thoracoscopic interventions for pediatric empyema.
Observation:
- Three pediatric patients with thoracic empyema were treated.
- Thoracoscopic debridement was performed using an ultrasonic surgical device (USUTM) in two cases.
- The USUTM aided in dissection and debridement of fibrinopurulent collections.
Findings:
- Successful treatment of pediatric empyema was achieved through thoracoscopic debridement.
- The ultrasonic surgical device facilitated effective debridement with minimal lung parenchyma injury.
- Early thoracoscopic intervention appears beneficial.
Implications:
- Thoracoscopic debridement is a viable and effective treatment for pediatric empyema.
- The use of ultrasonic surgical devices enhances debridement efficiency and safety.
- Early thoracoscopic intervention may obviate the need for open surgery or decortication in pediatric empyema cases.
Abstract:
Few studies have examined thoracoscopic treatment for pediatric empyema. We encountered three children with thoracic empyema successfully treated by thoracoscopic debridement. Patients were a 3-year-old girl, a 17 month-old boy and a 13-year-old girl who developed thoracic empyema during therapy for pneumonia. We performed dissection and debridement under thoracoscopy and resolved fibrinopurulent collections using an ultrasonic surgical device in two cases to search the dissection plane while minimizing injury to the lung parenchyma. Ultrasonic surgical device (USUTM) is very useful for performing effective debridement and irrigation with minimal pleural damage. Thoracoscopic debridement performed early in the course of therapy is recommended even for acute pediatric empyema and could prevent the unnecessary open surgical intervention or decortication.