Effect of Early Decortication in Treatment of Childhood Postpneumonic Empyema on Pulmonary Perfusion

Nesimi EREN, Behçet K. ENER, Gökalp ÖZGEN

Dicle Üniversitesi Tıp Fakültesi Göğüs Kalp ve Damar Cerrahisi ABD

Early decortication was performed in 66 (48%) of 137 patients with childhood postpneumonic empema treated at Dept. of Thoracic and Cardiovascular Surgery, Medical Shool of Dicle Univarsity from 1986 to 1992. Patients ages ranged between six months and 14 years ,with average 5.5 yr. Left side was involved in 34 patients (52%) and right side in 32 (48%). Remaininig 71 patients (92%) were treated classically. Bacteriological investigation revealed species of staphylacoci in 18 patients (27%), pseudomonas in 15 (24%) and pneumococci in 10 (15%).

Decortication was done for those cases in which lung expansion was not obtained within 10 to 12 days following intercostal chest tube drainage, antibiotherapy based on sensitivity tests of pleural fluid and pleural irrigation.

Preoperatively, CT scan and sinogram for the determining the size of pleural pouche were carried out and pulmonary perfusion sintigrams with Tc99 labelled maroaggregated albumin (MAA) to prove perfusion of the involved lung in 23 patients with mean 65 % perfusion loss were taken.

Postoperatively, perfusion defect of ten patients was found to be decreased below mean 4% in approximately third month. Average postoperative hospitalization stay lasted ten days.

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