Document Detail


Management of postpneumonic empyemas in children.
MedLine Citation:
PMID:  18557145     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
R Demirhan; A Kosar; I Sancakli; H Kiral; A Orki; B Arman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta chirurgica Belgica     Volume:  108     ISSN:  0001-5458     ISO Abbreviation:  Acta Chir. Belg.     Publication Date:    2008 Mar-Apr
Date Detail:
Created Date:  2008-06-17     Completed Date:  2008-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370571     Medline TA:  Acta Chir Belg     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  208-11     Citation Subset:  IM    
Affiliation:
Lutfi Kirdar Kartal Training and Research Hospital, Department of Thoracic Surgery, Erenkoy, Istanbul, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Chest Tubes
Child
Child, Preschool
Empyema, Pleural / etiology,  therapy*
Female
Fibrinolytic Agents / administration & dosage
Humans
Infant
Male
Pneumonia / complications
Retrospective Studies
Thoracostomy
Thoracotomy
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents

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