Resumen

MENDEZ, José H; ROGERS, Viviana C  y  HEINEN, Fernando L. Videotoracoscopia temprana en el tratamiento de las neumonías complicadas con derrame pleural en niños. Arch. argent. pediatr. [online]. 2006, vol.104, n.2, pp.127-132. ISSN 0325-0075.

Introduction. The management of complicated pneumonia with effusion in children has been controversial for a long time. Since 1992, video-assisted thoracic surgery has been proposed as a new procedure for the treatment of empyema and complicated pneumonia. Objective. To evaluate the results and applicability of the video-assisted thoracic surgery in children with complicated pneumonia with effusion. Population, material and methods. We retrospectively reviewed the medical records of 38 patients with complicated pneumonia with effusion admitted from April 1999 to March 2004, at the Department of Pediatric of the German Hospital. Patients were categorized in three groups based on the type of treatment used: Group I, patients treated with antibiotics alone; Group II, patients treated with antibiotics, thoracentesis or tube drainage; Group III, treated with antibiotics and early videoassisted thoracic surgery (VATS). Data collected included: age and gender of the patients, total length of hospital stay, preoperative and postoperative length of stay, days of chest tube permanence, days of intravenous antibiotics, number of reoperations performed. Results. The mean age of the three groups of patients was 4 years (range 1-12 years), 21 patients were girls and 17 were boys. Distribution was: 12 patients in Group I (31.6%), 17 in Group II (44.7%) and 9 in Group III (23.7%). The total length of hospital stay was shorter in Group III (7.22 ± 0.77) than in Group II (12.4 ± 2.15). There was a difference in the number of days of intravenous antibiotics in the patients of Group III compared with Group II (6.22 ± 0.77 vs. 11.5 ± 2,15, p=0.058). There were no surgical reinterventions after video-assisted thoracic surgery in Group III. (p= 0.03). Conclusions. Our initial experience with early videoassisted thoracic surgery for the management of complicated pneumonia with effusion shows a decrease in total hospital stay, need of intravenous antibiotics, and surgical reintervention.

Palabras clave : Empyema; Video-assisted thoracic surgery; Pneumonia; Pleural effusion; Children.

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