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The Effect of CT-Guided Artificial Pneumothorax plus Thoracoscopy and Central Venous Catheterization on the Drainage

Xiaoping Liu1,2,3, Yanxia Yang1,2,3, Xueping Ma1,4

  • 1Northwest University for Nationality School of Clinical Medicine, Lanzhou, China.

Contrast Media & Molecular Imaging
|September 16, 2022
PubMed

Insights

CT-guided artificial pneumothorax with thoracoscopy and central venous catheter improves pediatric empyema drainage, reducing bleeding and trauma. This method enhances pulmonary function recovery and lowers complication rates, making it a valuable clinical option.

Area of Science:

  • Pediatric Thoracic Surgery
  • Interventional Pulmonology
  • Medical Imaging in Pediatrics

Background:

  • Pediatric empyema requires effective drainage strategies to prevent long-term sequelae.
  • Traditional thoracoscopic procedures may have limitations in achieving complete drainage and optimal pulmonary recovery.
  • Minimally invasive techniques are crucial for improving outcomes in pediatric thoracic infections.

Purpose of the Study:

  • To evaluate the efficacy of CT-guided artificial pneumothorax combined with thoracoscopy and central venous catheter for empyema drainage in children.
  • To compare the impact of this technique versus standard thoracoscopy on pulmonary function and clinical outcomes.
  • To assess the safety and feasibility of the CT-guided approach in pediatric empyema management.

Main Methods:

  • Retrospective analysis of 82 pediatric patients with empyema.
  • Comparison between a study group (CT-guided artificial pneumothorax, thoracoscopy, central venous catheter) and a control group (artificial pneumothorax, thoracoscopy).
  • Evaluation of operative indicators, inflammatory markers, pulmonary function tests (spirometry, cardiopulmonary exercise test), and adverse events.

Main Results:

  • The CT-guided group showed statistically significant improvements in operation time, intraoperative blood loss, postoperative hospital stay, drainage volume, and surgical field exposure (P < 0.05).
  • Pulmonary function tests at 6 months post-operation revealed significantly higher FVC (%), FEV1 (%), FEV1/FVC, and MVV (%) in the study group compared to the control group (P < 0.05).
  • The incidence of chest pain, pulmonary edema, and skin infection was significantly lower in the CT-guided group (P < 0.05).

Conclusions:

  • CT-guided artificial pneumothorax combined with thoracoscopic and central venous catheter drainage offers a more thorough and less invasive approach for pediatric empyema.
  • This technique leads to reduced bleeding, trauma, and faster recovery of pulmonary function.
  • The procedure is recommended for clinical promotion due to its favorable outcomes and safety profile.

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