The role of thoracoscopy in the treatment of pleural empyema in children
Originally described in the early 20th century, the technique of thoracoscopy was first applied to children in the mid 1970s. Since that time, the technique has become adopted widely by pediatric surgeons and is currently considered to be the optimum technique for management of many intrathoracic disorders in children. In most pediatric surgical practices, the most common indications for thoracoscopy include pleural debridement for empyema, mediastinal lymph node biopsy, and pulmonary parenchymal biopsy for inflammatory infiltrates or nodules. With proper adherence to patient selection and preoperative imaging as well as appropriate anesthetic techniques, this procedure has proven to be extremely accurate in achieving a diagnosis and very successful in treating most patients. Postoperative recovery is rapid, and complications of the procedure have been relatively infrequent. As pediatric surgeons gain more experience with this technique and as better instrumentation becomes available, thoracoscopy surely will be used for an increasing number of complex intrathoracic disorders.