Hawaii Surgical Residency Program, Honolulu, HI 96813, USA.
J Pediatr Surg. 2010 Mar;45(3):574-8. doi: 10.1016/j.jpedsurg.2009.10.047.
Lung abscesses in the pediatric population are relatively rare. We present our consecutive series of thoracoscopically treated pediatric lung abscesses.
A retrospective review of children who underwent thoracoscopic drainage of intraparenchymal lung abscesses between October 2006 and January 2009 at a tertiary referral center. All patients had associated parapneumonic empyema and underwent drainage of the abscess concurrently with thoracoscopic treatment of the empyema.
Eleven children (4 boys and 7 girls) had thoracoscopic intervention for lung abscesses. A total of seventeen abscesses were drained. All procedures were completed thoracoscopically. There were no mortalities or long-term bronchopleural fistulas. No child required a formal thoracotomy, lung resection or a second operation. Mean duration of postoperative hospital stay was 11.0 days (range, 3-36). Mean length of stay was 19.5 days (range, 6-77 days). Mean duration of postoperative chest tube was 3.6 days (range, 2-8). Mean length to defervescence was 4.8 days (range, 1-11 days). Mean duration of postoperative antibiotics was 23.6 days (range, 3-56). Eight children had organisms identified from intraoperative cultures.
Thoracoscopic drainage of pediatric lung abscesses is a viable and safe treatment option. Thoracoscopic abscess drainage is associated with minimal morbidity and may result in faster recovery and a shorter course of antibiotics.
儿童肺脓肿相对少见。我们报告了一系列连续的经胸微创治疗儿童肺脓肿病例。
回顾性分析 2006 年 10 月至 2009 年 1 月在一家三级转诊中心接受经胸微创引流肺脓肿的儿童患者。所有患者均伴有肺炎旁胸腔积脓，在经胸微创治疗脓胸的同时，引流脓肿。
11 例（4 男 7 女）患儿因肺脓肿接受经胸微创干预。共引流 17 个脓肿。所有操作均经胸微创完成。无死亡病例或长期支气管胸膜瘘。无一例患儿需要开胸手术、肺切除术或二次手术。术后平均住院时间为 11.0 天（3-36 天）。平均住院时间为 19.5 天（6-77 天）。术后胸腔引流管留置时间平均为 3.6 天（2-8 天）。退热平均时间为 4.8 天（1-11 天）。术后抗生素平均使用时间为 23.6 天（3-56 天）。8 例患儿的术中培养物中发现了病原体。
经胸微创引流儿童肺脓肿是一种可行且安全的治疗选择。经胸微创脓肿引流的并发症发生率低，可能导致更快的康复和更短的抗生素疗程。
