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Childhood chronic pleural empyema: a continuing surgical challenge in developing countries
1Department of Thoracic and Cardiovascular Surgery, Turgut Ozal Medical Center, Malatya, Turkey.
Insights
Surgical intervention remains crucial for chronic pleural empyema in children, particularly in developing nations. High success rates are observed for non-tuberculous cases, with acceptable outcomes for tuberculous empyema.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Infectious Diseases
Background:
- Childhood chronic pleural empyema often necessitates surgical intervention.
- A retrospective review of 104 pediatric surgical cases over 21 years was conducted.
Purpose of the Study:
- To elucidate the role, indications, and outcomes of surgical treatment for childhood chronic pleural empyema.
Main Methods:
- Retrospective analysis of 104 pediatric patients who underwent surgery for chronic pleural empyema.
- Data collected included etiology, surgical indications, procedures, and success rates.
Main Results:
- Pneumonia was the most common cause (69/104).
- Key indications for surgery included severe pleural thickening (51.9%) and trapped lung (34.6%).
- Decortication was the primary surgical procedure (90/104), achieving 93% success in non-specific empyema and 54% in tuberculous empyema.
Conclusions:
- Surgical treatment is essential for childhood chronic pleural empyema, especially in developing countries.
- High success rates are achievable for non-specific empyema, while outcomes for tuberculous empyema are acceptable.
Background:
Surgical treatment may be necessary in childhood chronic pleural empyema.
Methods:
Over a 21-year period 642 children with pleural empyema were hospitalized and 104 of them underwent surgical treatment. The records of the children who underwent surgery for the treatment of empyema were retrospectively reviewed to describe the role, indications, and results of surgical treatment of childhood chronic pleural empyema.
Results:
Etiologic diseases or conditions leading to empyema were pneumonia in 69 patients, tuberculosis in 13, hydatid cyst in eight, postpneumonectomy empyema in five, and other causes in nine patients. Indications for surgery were severe pleural thickening in 54 cases (51.9%), trapped lung in 36 cases (34.6%), loculated empyema in eight cases (7.7%) and broncho-pleural fistula in six cases (5.8%). Operations performed were decortication in 90 patients, pulmonary resection and decortication in seven, muscle flap closure in five, and pneumonectomy in two. Success rates in the treatment of nonspecific and tuberculous empyema were 93% and 54%, respectively.
Conclusions:
Surgical treatment is still necessary in childhood pleural empyema in developing countries, and success rates are very high in nonspecific pleural empyema and acceptable in tuberculous pleural empyema.