Thoracoscopic treatment of pediatric lung abscesses.

OBJECTIVE: Lung abscesses in the pediatric population are relatively rare. We present our consecutive series of thoracoscopically treated pediatric lung abscesses.

METHODS: A retrospective review of children who underwent thoracoscopic drainage of intraparenchymal lung abscesses between October 2006 and January 2009 at a tertiary referral center. All patients had associated parapneumonic empyema and underwent drainage of the abscess concurrently with thoracoscopic treatment of the empyema.

RESULTS: Eleven children (4 boys and 7 girls) had thoracoscopic intervention for lung abscesses. A total of seventeen abscesses were drained. All procedures were completed thoracoscopically. There were no mortalities or long-term bronchopleural fistulas. No child required a formal thoracotomy, lung resection or a second operation. Mean duration of postoperative hospital stay was 11.0 days (range, 3-36). Mean length of stay was 19.5 days (range, 6-77 days). Mean duration of postoperative chest tube was 3.6 days (range, 2-8). Mean length to defervescence was 4.8 days (range, 1-11 days). Mean duration of postoperative antibiotics was 23.6 days (range, 3-56). Eight children had organisms identified from intraoperative cultures.

CONCLUSIONS: Thoracoscopic drainage of pediatric lung abscesses is a viable and safe treatment option. Thoracoscopic abscess drainage is associated with minimal morbidity and may result in faster recovery and a shorter course of antibiotics.