Surgical treatment of pleural empyema in children

Objective To summarize the experience of surgical treatment of pleural empyema in children and to investigate the best intervention time of different surgical therapies.Methods From Jun.1993 to Jan.2006,98 children with pleural empyema were treated surgically.Different surgical therapies were chosen depending on the phase of pleural empyema development.Ten children underwent thoracentesis.Thoracic close drainage was performed on 38 cases,and closed chest drainage by rib resection on 43 cases,decortication on 7 cases respectively.Results All the 98 children were cured.Among them,closed chest drainage by rib resection followed thoracentesis in 43 cases or thoracic close drainage in 3 cases,and decortication followed closed chest drainage by rib resection in 2 cases.The result of long term follow-up was satisfied.Conclusion After diagnosis,optimal therapeutic intervention should be applied as soon as possible.Children with pleural empyema can be successfully treated with early thoracentesis or thoracic close drainage for the free-flowing effusion,and closed chest drainage by rib resection or decortication of the visceral pleura for multiloculated effusion and advanced empyema.