Postpneumonic empyema in children treated by early decortication

We performed early decortication in 32 cases of postpneumonic empyema during the period of February 1991 to December 1995. Twenty of them were male and 12 of them were female. We evaluated these cases retrospectively. Decortication was saved for the patients where antimicrobial therapy and closed-tube drainage had failed to achieve a cure and was performed on the 10-15th day after the diagnosis was established. Indications for the decortication were persistent fever (9), pulmonary air leakage (7), localized effusion (7), persistent respiratory distress (5) and pleural thickening without resolution (28). Decortication was performed through the standard posterolateral thoracotomy. Patients were discharged on the 8th postoperative day with minimal morbidity and no mortality. Because of the simplicity of the procedure (short hospitalization periods, low mortality and morbidity rates) good results were achieved with early decortication.