Thoracoscopic decortication in infants and children.
BACKGROUND
The treatment of pediatric empyemas remains controversial. While thoracentesis and tube thoracostomy appear adequate for relatively benign organisms, virulent bacteria cause thick fibrinous pleural peels entrapping the lung. Open thoracotomies have been effectively used for decortication but are painful.


METHODS
We report the use of minimally invasive thoracoscopic decortication in 12 patients (mean age 5 years). All failed conventional management with persistent fever, increasing oxygen requirement, recurrent effusion, and pleural consolidation; 5- and 10-mm trocars were used and complete decortication was accomplished.


RESULTS
Ten of 12 patients were afebrile by 72 h and discharged 4-12 days after surgery. Eleven of 12 patients had clear chest x-rays by 1 month.


CONCLUSIONS
Thoracoscopic decortication is a safe and effective means of treating pediatric empyemas.
Rothenberg
S S
SS
Columbia-HealthONE Presbyterian, St. Luke's Hospital, 1601 East Nineteenth Avenue, Suite 5200, Denver, CO 80218, USA.
Chang
J H
JH
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004646:Emphysema / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008168:Lung / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000209:etiology*; D011859:Radiography; D020708:Thoracoscopes; D013906:Thoracoscopy / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome