Thoracoscopy in the management of empyema in children
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Abstract
The main complication of bacterial pneumonia in children is the paraneumonic effusion (40%) and a prevalence of empyema is reported in 2% of cases. The management of this pathology in the pediatric population is controversial, being described from the management with antibiotic therapy, drainage with chest tube, fibrinolysis, thoracotomy and video-assisted thoracoscopy.
Objective: To describe the initial experience in the management of empyema in children by video-assisted thoracoscopy in the Hospital Infantil San Vicente Foundation.Methods: Retrospective study with pediatric patients undergoing video-assisted thoracoscopy for the management of empyema from August 2013 to November 2015. Using a medical history review
Results: Eighteen children underwent video-assisted thoracoscopy for the management of empyema, mean age 37 months. Ten male patients; average clinical presentation of 10 days, mean of hospitalization of 21 days. The procedure had an average duration of 117 minutes. Management failure was considered in 3 patients and the average duration of the chest tube was 8 days.
Conclusions: Video-assisted thoracoscopy is a safe and useful procedure in the management of children with empyema, with low complication rates. It should be compared with studies that evaluate the medical management of this pathology in order to create algorithms for treatment of empyema in our children's hospital.
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