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Thoracoscopic decortication in infants and children
1Columbia-HealthONE Presbyterian, St. Luke's Hospital, 1601 East Nineteenth Avenue, Suite 5200, Denver, CO 80218, USA.
Surgical Endoscopy
|February 1, 1997
Summary
Minimally invasive thoracoscopic decortication effectively treats pediatric empyemas. This procedure offers a safe and successful alternative for children with complicated pleural infections unresponsive to conventional therapies.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Infectious Diseases
Background:
- Pediatric empyema treatment is controversial, especially for infections caused by virulent bacteria.
- Thick fibrinous pleural peels can entrap the lung, necessitating effective drainage and lysis.
- While open thoracotomy is effective for decortication, it is associated with significant pain.
Purpose of the Study:
- To evaluate the safety and efficacy of thoracoscopic decortication in pediatric empyema.
- To assess the outcomes of minimally invasive surgery in children who failed conventional management.
Main Methods:
- Retrospective case series of 12 pediatric patients (mean age 5 years) with empyema.
- All patients had failed conventional treatments including persistent fever and pleural consolidation.
- Minimally invasive thoracoscopic decortication was performed using 5- and 10-mm trocars.
Main Results:
- Ten of 12 patients became afebrile within 72 hours post-surgery.
- Hospital discharge occurred between 4-12 days after the procedure.
- Eleven of 12 patients demonstrated clear chest X-rays by one month post-thoracoscopy.
Conclusions:
- Thoracoscopic decortication is a safe and effective treatment for pediatric empyemas.
- Minimally invasive approach provides successful outcomes for complicated pleural infections.