ABSTRACT
Objetivo. Comparar el uso de la toracoscopia primaria y secundaria en niños con empiema paraneumónico. Material y métodos. Efectuamos un estudio retrospectivo de 24 niños ingresados en nuestro hospital entre los años 1998 y 2003. Resultados. La toracoscopia precoz no influye en el número de días de ingreso tras la misma. De los 24 niños, 12 (50%) fueron tratados con drenaje pleural previo y otros 12 (50%) sin él. La mayor diferencia se establece en cuanto a la estancia media total. El número de días de desaparición de la fiebre tras toracoscopia es el mismo, no así desde el inicio de la enfermedad que se disminuye notablemente. Conclusión. La toracoscopia precoz disminuye en número de días de estancia media en el hospital y de desaparición de la fiebre desde el inicio de la enfermedad (AU)
Objective. To compare the use of primary and secondary thoracoscopy in children with parapneumonic empyema. Material and méthods. We present a retrospective study of 24 children entered our hospital between years 1998 and 2003. Results. Early thoracoscopy doesnt influence in length of stay. 12 children (50%) were treated with previous chest tube and other 12 children (50%) without it. There is statistical significance in length of hospital stay. The days with postoperative fever didnt decrease, but it was seen if we compare it from the beginning of the disease. Conclusions. An early thoracoscopy decrease length of hospital stay and the duration of fever postoperative (AU)
Subject(s)
Male , Female , Child , Humans , Empyema, Pleural/diagnosis , Empyema, Pleural/surgery , Thoracoscopy/methods , Pleural Effusion/complications , Pleural Effusion/diagnosis , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Thoracotomy/methods , Pneumothorax/complications , Pneumothorax/diagnosis , Retrospective Studies , Fibrinolytic Agents/therapeutic useABSTRACT
Pulmonary neoplasia in children is usually due to methastatic disease because primary lung tumors are very unfrequent. Due to its' rarity they are usually not included in the differential diagnosis of lung masses, so treatment is delayed and prognosis is worsened. Herein, we show our experience in the management of five primary tumors of the lung or the airway: one tracheal, three bronchial, and another intraparenchymatous. We study the clinical behaviour, diagnostic work-up, treatment, histology, and follow-up. Despite its rarity, a diagnosis of pulmonary tumor should be considered in any child with respiratory symptoms that does not improve with standard therapy. An early and accurate diagnosis and an adequate treatment are crutial in the prognosis of these patients.
Subject(s)
Lung Neoplasms/pathology , Adolescent , Bronchoscopy , Child, Preschool , Female , Humans , Infant, Newborn , Lung/diagnostic imaging , Lung/pathology , Lung/surgery , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Male , Pneumonectomy , Retrospective Studies , Tomography, X-Ray Computed , Treatment OutcomeSubject(s)
Neck Injuries/complications , Trachea/injuries , Wounds, Nonpenetrating/complications , Child , Humans , Male , Rupture/diagnosisABSTRACT
INTRODUCTION: Stenosing airway disease is unfrequent in the pediatric age group and includes intraluminal obstructions, extrinsic compressions and malacias. OBJECTIVE: To show our experience in the treatment of congenital and acquired tracheal stenosis (CTS and ATS) and suprastomal tracheal collapse (STC). PATIENTS AND METHODS: Since 1990, 24 patients have been evaluated in our Unit: Ten CTS, 5 ATS and 9 STC. We have studied the following parameters: Sex, age at diagnosis, ethiology, type of lesion, associated anomalies, treatment, postoperative intubation, length of hospital stay, number of bronchoscopies, complications and follow-up. RESULTS: 14 girls and 10 boys are included in this survey. Age at diagnosis ranged from 3 days to 12 years and associated anomalies were present in 75% of cases. We have treated 22 of the 24 patients with the following procedures: Costal cartilage tracheoplasty (6 cases), slide tracheoplasty (2), resection and anastomosis (3), anterior cricoid suspension (8), dilation (2) and laser resection (1). We have achieved good results in 17 patients (77%), bad in 4 (18%) and fair in one. CONCLUSIONS: Due to the variety of stenotic lesions, we think that treatment should be tailored to each particular case and performed by a multidisciplinary pediatric team in order to achieve the best results.
Subject(s)
Tracheal Stenosis/surgery , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , MaleSubject(s)
Bronchial Diseases/therapy , Stents , Tracheal Diseases/therapy , Equipment Design , Humans , Infant, Newborn , Male , Severity of Illness IndexABSTRACT
Congenital tracheal stenosis (CTS) is a rare malformation that usually require corrective surgery. Resection and tracheal anastomosis is the treatment of choice when the stenosis is short. However, such an approach is not usually viable when the CTS is long, given that anastomotic pressure would be too great. New surgical techniques have allowed this serious airway malformation to be corrected satisfactorily. We report the case of a three-year-old boy with a long CTS (51% of the length of the trachea) treated with a new reconstructive technique called slide tracheoplasty. Outcome was excellent.
