Thoracoscopy in complicated parapneumonic effusion in children
DOI:
https://doi.org/10.22491/2357-9730.125265Keywords:
Empyema, thoracoscopy, pleuroscopyAbstract
OBJECTIVE: The aim of the present study was to evaluate our experience with
thoracoscopy in complicated parapneumonic pleural effusion.
MATERIALS AND METHODS: We carried out a retrospective review of 23 children
(12 girls), median age 3.2 years, operated at Hospital de Clínicas de Porto Alegre, from
July 1995 to July 1998. Indications for thoracoscopy were residual pleural effusion and
fever in the patients initially submitted to closed thoracic drainage
(n = 20), and presence of complicated pleural effusion with septations in the others
(n = 3). Thoracoscopy was performed with a mediastinoscope (n = 8) or a
videothoracoscope (n = 15). Five children needed to redo thoracoscopy due to the presence of fever and loculated pleural liquid after the removal of the thoracic drain.
Three children required open drainage (pleurotomy in two and section and aperture of
the thoracic drain in one).
RESULTS: All children had a full clinical recovery. Comparison among children who
performed thoracoscopy with a mediastinoscope and with videothoracoscope did not
show any statistically significant difference.
CONCLUSIONS: We concluded that thoracoscopy should be used in children with
residual pleural effusion and fever, during or after chest drainage, and should be
considered as the first-line therapy in children with fibrinopurulent effusion; there is
no difference between the performance of thoracoscopy with a mediastinoscope or
videothoracoscope.
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