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Published on: November 10, 2023
Surgical management of complicated parapneumonic pleural effusion in children
Anca Budusan1, Ioan Paraian1, Doina Zamora1
1Children's Hospital Cluj-Napoca, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Insights
Management strategies for pediatric parapneumonic pleural effusions show good short-term outcomes with low morbidity and mortality. Chest drains alone can lead to recovery, though some cases may require surgery.
Area of Science:
- Pediatric Surgery
- Thoracic Medicine
Background:
- Parapneumonic pleural effusions are common in children.
- Management strategies vary, impacting patient outcomes.
Purpose of the Study:
- To analyze the effect of different management strategies on short-term outcomes for pediatric patients with parapneumonic pleural effusions.
Main Methods:
- Retrospective review of 16 pediatric cases treated for empyema or pleural effusions over 30 months.
- Analysis of management strategies including chest drains and surgical interventions.
Main Results:
- Complete recovery is achievable with chest drains alone, albeit with longer hospital stays.
- Some patients require advanced surgical treatment, such as open thoracotomy with decortication, due to treatment failure.
Conclusions:
- Short-term outcomes for pediatric parapneumonic pleural effusions are generally favorable, with low morbidity and mortality.
- While effective, current management approaches may incur higher costs and have limitations due to the lack of advanced equipment like VATS or fibrinolytic therapy.
Aims:
We analyzed and examined the effect of different management strategies on short term outcomes for pediatric patients with parapneumonic pleural effusions.
Patients And Methods:
We retrospectively reviewed 16 cases of children admitted and treated in our department of pediatric surgery for empyema or pleural effusions for a period of 30 months.
Results:
When chest drains are used alone, patients can make a complete recovery, even with the cost of longer hospital stay. Furthermore, some patients often require extensive surgical treatment as open thoracotomy with decortication due to failure to respond to chest-tube drainage.
Conclusions:
Because of the relatively small number of patients with parapneumonic effusions and because of lack of modern possibilities that require expensive equipment, like VATS or fybrinolitic therapy, our study results are limited and need to be reviewed in time. Even so, results on short outcome are good, with low morbidity and mortality, but with higher costs.
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