Management of postpneumonic empyemas in children
Acta Chirurgica Belgica, cilt.108, sa.2, ss.208-211, 2008 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 108 Sayı: 2
- Basım Tarihi: 2008
- Doi Numarası: 10.1080/00015458.2008.11680205
- Dergi Adı: Acta Chirurgica Belgica
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.208-211
- Anahtar Kelimeler: Chest tube thoracostomy, Decortication, Empyema, Fibrinolysis
- Maltepe Üniversitesi Adresli: Evet
Özet
Objective: The optimal treatment of children with empyema remains controversial. The purpose of this clinical retrospective study was to assess different treatment options in the management of postpneumonic pediatriC empyemas. Methods: From April 1997 to October 2005, 111 consecutive children (57 boys and 54 girls) were managed for pleural empyema. The mean age was 7.07 years (range: 18 months-14 years). Patients were divided into 3 groups depending on the treatment received: group I, chest tube alone (n = 89) ; group II, chest tube with fibrinolytics (n = 22) ; group III, thoracotomy with decortication (n = 19, consisting of 9 patients of group I and 10 of group II with unsuccessful treatment results). Results: Chest tube alone, chest tube with fibrinolytics, and thoracotomy with decortication had complete response rates of 89.9%, 54.5%, and 100%, respectively. The hospital stay was 11.46 ± 3.79 days for group I, 9.08 ± 2.07 days for group II, and 6.32 ± 2.54 days for group III. There was no statistically significant difference between group I and group II with regard to hospital stay (P = 0.040). Mild pain occurred in 4 children of group II after streptokinase instillation. Only one atelectasis appeared in group III during the postoperative period. Conclusion: Chest tube drainage is a safe, effective primary treatment of postpneumonic pediatriC empyema. In cases where it is insufficient, thoracotomy with decortication can be used successfully with low morbidity and mortality rates.