Single port thoracoscopy for the treatment of pleural empyema in children

Background/Purpose: This report is an evaluation of a single-port technique for the thoracoscopic treatment of pleural empyema in children. Methods: Ten consecutive patients with pleural empyema were treated by means of a "Single Port Thoracoscopy" (SPOT). Mean age was 6.9 years (range, 2 to 13 years). The surgery was performed 5 to 26 days after the onset of symptoms. Three patients received this treatment as the first procedure, whereas the other 7 underwent closed placement of a chest tube, 3 to 12 days before the surgery. Only 1 11.5-mm thoracoport was used. Through this single port, standard scopes and instruments were introduced simultaneously to debride and unify the pleural space. Results: Satisfactory debridement of the pleural cavity was achieved in all cases. Mean operating time was 70 minutes (range, 60 to 140). There were no intraoperative complications. The chest tube was removed 2 to 5 days after the surgery. Eight patients remained afebrile from the day of the surgery, and 2 had mild fever that disappeared 36 hours after the surgery. Mean hospital stay after SPOT was 4 days (range, 3 to 7). Conclusions: SPOT is a safe and effective proceeding for the treatment of pleural empyema in children with the advantage of better cosmetic results than the multiport techniques. (C) 2004 Elsevier Inc. All rights reserved.