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Postpneumonic empyema in children treated by early decortication
Insights
Early decortication for postpneumonic empyema offers good results. This surgical procedure, performed 10-15 days post-diagnosis, showed minimal morbidity and no mortality in 32 patients.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Infectious Diseases
Background:
- Postpneumonic empyema requires effective treatment when initial therapies fail.
- Early surgical intervention may improve outcomes in complex cases.
Purpose of the Study:
- To evaluate the efficacy and safety of early decortication for postpneumonic empyema.
- To assess outcomes in patients treated with decortication after failure of antimicrobial therapy and closed-tube drainage.
Main Methods:
- Retrospective evaluation of 32 patients undergoing early decortication (10-15 days post-diagnosis).
- Standard posterolateral thoracotomy was the surgical approach.
- Indications included persistent fever, air leakage, localized effusion, respiratory distress, and pleural thickening.
Main Results:
- All 32 patients (20 male, 12 female) were treated successfully.
- Patients were discharged on average postoperative day 8.
- The procedure demonstrated minimal morbidity and no mortality.
Conclusions:
- Early decortication is a simple and effective procedure for managing postpneumonic empyema.
- The approach is associated with short hospitalization periods, low mortality, and low morbidity rates.
Abstract:
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.