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Surgical treatment of childhood pleural empyema
1Department of Thoracic Surgery, Atatürk Chest Diseases and Surgical Center, Ankara, Turkey.
Insights
Tube drainage is an effective surgical treatment for childhood pleural empyema. This method, combined with antibiotics, offers successful outcomes with minimal need for further surgical intervention.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Infectious Diseases
Background:
- Childhood pleural empyema is a serious condition requiring effective treatment.
- Surgical interventions have varied historically, with differing success rates.
Purpose of the Study:
- To evaluate the efficacy of surgical treatments for childhood pleural empyema.
- To determine the optimal surgical approach for pediatric pleural empyema.
Main Methods:
- Retrospective analysis of 175 patients treated between June 1977 and January 1987.
- Surgical procedures included tube drainage, decortication, pleuropneumonectomy, lobectomy, and thoracoplasty.
- Follow-up assessments involved chest radiographs over a mean of 32 months.
Main Results:
- Tube drainage was the primary treatment in 90% of cases, with low hospital mortality (1.1%).
- Late recurrences were rare, with only one case requiring additional surgery.
- Chest tube drainage demonstrated superior effectiveness compared to other surgical procedures.
Conclusions:
- Antibiotics and early-stage chest tube drainage are effective for childhood loculated empyema.
- Tube drainage is the preferred surgical method, minimizing the need for extensive procedures.
- Surgical intervention for pediatric pleural empyema can achieve favorable long-term outcomes.
Abstract:
From June 1977 to January 1987, 175 patients underwent surgical treatment of childhood pleural empyema. The surgical treatment consisted of tube drainage in 159 (90%) cases, decortication in 31 (17%) cases, pleuropneumonectomy in 2, lobectomy in 1, and partial thoracoplasty in one cases. There were 2 hospital deaths (14 and 26 days after admission). Late recurrences didn't occur, except in one case where a partial thoracoplasty was necessary. During the follow-up of 11 to 120 months (mean 32 months) examinations were done by chest radiographs. We believe that, children with loculated empyema can be treated successfully with antibiotics and chest tube drainage in early stage. The tube drainage is a more effective method than the other surgical procedures. Few patients require open drainage, and further surgery is rarely required.