TITLE:
Management for Pediatric Pleural Empyema in Resource-Poor Country: Is Chest Tube Drainage with Antiseptic Lavage-Irrigation Better than Tube Thoracostomy Alone?
AUTHORS:
Seydou Togo, Moussa Abdoulaye Ouattara, Ibrahim Sangaré, Jacque Saye, Cheik Amed Sékou Touré, Ibrahim Boubacar Maiga, Dokore Jerome Dakouo, Liang Guo, Sékou Koumaré, Adama Konoba Koita, Zimogo Zié Sanogo, Sadio Yéna
KEYWORDS:
Empyema, Thoracis, Children, Irrigation, Drainage
JOURNAL NAME:
Surgical Science,
Vol.6 No.12,
December
28,
2015
ABSTRACT: Drainage by chest tube thoracostomy
is widely used in treatment of early empyema thoracis in children, but drainage
with antiseptic lavage-irrigation is more frequent in our context since the last
20 years. This study was to determine which was more effective in our experience
comparing chest tube drainage with catheter antiseptic lavage-irrigation versus
drainage by chest tube thoracostomy alone in the management of empyema thoracis
in children. Patients and Methods: Demographic, clinical and microbiological data
on children with thoracic empyema undergoing drainage by chest tube thoracostomy
alone or with antiseptic lavage-irrigation were obtained from 2 thoracic surgical
centers from September 2008 to December 2014. It was a retrospective study included
246 children (137 boys and 109 girls) who were managed for empyema thoracis at the
author’s different department of surgery. Outcomes analysis with respect to treatment
efficacy, hospital duration, chest tube duration, hospital costs, and need for subsequent
procedures was analyzed and compared in the 2 groups. Results: Drainage of pus and
antiseptic irrigation resulted in resolution of pyrexia with improvement in general
condition in 85.82% of patients in group 1 and by tube thoracostomy alone in 73.95%
in group 2. There are a significant difference in the length of hospital stay (p
= 0.022), duration of chest tubes in situ (p = 0.040), treatment coast (p = 0.015) and outcome of stage 2 empyema disease
(p = 0.037) between the 2 groups. Conclusion: it seems that chest tube drainage
with antiseptic lavage-irrigation method is associated with a higher efficacy, shorter
length of hospital stay, shorter duration of chest tube in situ, less cost and better outcome of stage 2 empyema diseases than
a treatment strategy that utilizes chest tube thoracostomy alone.