Çocuklarda Plevral Ampiyemde Video Yardımlı Torakoskopik Dekortikasyonun Sonuçları

Amaç: Bu çalışmanın amacı, çocukluk çağı ampiyeminde iki port tekniği ile video yardımlı torakoskopik cerrahinin (VATS) etkinlik, güvenlik ve uygulanabilirliğini belirlemektir. Gereç ve Yöntemler: Çalışmaya 17 yaş altı 34 hasta dahil edildi. Hastaların demografik ve klinik verileri geriye dönük olarak kaydedildi. Bulgular: Çalışmaya 17 yaş altı 34 hasta dahil edildi. Şikayetlerin ilk başladığı gün 12 gündü. Hastaların şikayetleri başladıktan ortalama 12 (2-46) gün sonra VATS uygulandı. Ampiyem 21 çocukta sağ hemitoraksta, 11 çocukta sol taraftaydı. İki hastaya bilateral dekortikasyon uygulandı. Drenaj için takılan göğüs tüpünün çıkarılma süresi ortalama 9.70 (2-26) gündü. Ameliyat sonrası kalış süresi 23.50 (4-120) gün iken, toplam hastanede kalış süresi 32.50 (7-142) gündü. Takipler sırasında 7 hastada amfizem gelişti. Bir hastaya göğüs tüpü revizyonu yapıldı. 6 hastada spontan geriledi. İki çocuk solunum arresti ve karaciğer nakli sonrası torakoskopi dışı nedenlerden exitus oldu. Sonuç: VATS, çocuklarda plevral ampiyemde sonuçları iyi olan, uygulanabilir bir yöntemdir. Sonuçlar hastalığın erken veya geç döneminde tatmin edicidir.

Anahtar Kelimeler:

Çocuk, Ampiyem, Cerrahi, Torakoskopik, VATS

Outcomes of Video-Assisted Thoracoscopic Decortication in Pleural Empyema in Children

Objectives: The aim of this study is to determine efficacy, safety, and feasibility of video-assisted thoracoscopic surgery (VATS) in childhood empyema with two port technique. Materials and Methods: 34 patients under 17 years of age were included to the study. Demographic and clinical data of the patients were recorded retrospectively. Results: 34 patients under 17 years of age were included in the study. The first time the complaints started was 12 days. VATS was performed on mean 12 (2-46) days after the complaints of the patients started. The empyemas were in right hemithorax in 21 children and left in 11. Two patients underwent bilateral decortication Mean of chest tube removal time was 9.70 (2-26) days. While the postoperative stay was 23.50 (4-120) days, the total hospital stay was 32.50 (7-142) days. Emphysema developed in 7 patients in the following period. Chest tube revision was performed in a patient. Emphysema spontaneously regressed at follow-up in 6 patients. Two children had died due to 1- arrest and 2 – after liver transplant. Conclusion: VATS is a feasible method with good results pleural empyema in children. The results are satisfactory in the early or late period of disease.

Keywords:

VATS, Children, Empyema, Surgery, Thoracoscopic,

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