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[Pleural cavity concerns].

I Simal1, M A García-Casillas1, J Cerdà1

  • 1Servicio de Cirugía Pediátrica. Hospital General Universitario Gregorio Marañón. Madrid.

Cirugia Pediatrica : Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica
|October 19, 2017
PubMed
Summary
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Persistent air leak (PAL) management in pediatric patients is crucial. Intraoperative techniques and autologous blood pleurodesis show promise in reducing PAL incidence and effectively treating persistent air leaks.

Area of Science:

  • Thoracic Surgery
  • Pediatric Surgery
  • Pulmonary Medicine

Background:

  • Persistent air leak (PAL) is a frequent complication following thoracic procedures.
  • Effective management strategies for PAL in pediatric patients are essential.

Purpose of the Study:

  • To assess the experience in managing pediatric patients with persistent air leak.
  • To identify risk factors and evaluate treatment outcomes for PAL.

Main Methods:

  • Retrospective review of pediatric patients (0-16 years) with chest tubes from 2010-2015.
  • Analysis of clinical data, PAL incidence, risk factors, and treatment modalities for PAL (≥5 days).
  • Evaluation of intraoperative techniques, including staple-line reinforcement and tissue sealants, and pleurodesis procedures.
Keywords:
Bronchial fistulaChest tubesPleurodesisPneumothoraxRespiratory tract fistula

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Main Results:

  • Thirty-seven cases (28 patients) were analyzed, primarily following lung resections and pneumothorax.
  • Staple-line reinforcement and tissue sealants showed trends towards lower PAL incidence.
  • Pleurodesis, particularly autologous blood instillation, demonstrated 70% effectiveness with a favorable safety profile, despite some instances of fever.

Conclusions:

  • Intraoperative technical aspects play a significant role in minimizing the risk of PAL.
  • Autologous blood pleurodesis is a safe and effective minimally invasive option for treating parenchymal PAL in pediatric patients.