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The Journal of Cardiovascular Surgery 1998 December;39(6):849-51

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Management of pneu­moth­o­rax in chil­dren

Genc A., Ozcan C., Erdener A., Mutaf O.

From the Department of Pediatric Surgery Ege University, Faculty of Medicine, Izmir, Turkey


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Background. The effi­ca­cy of ­tube thor­a­cos­to­mies insert­ed at the ­sixth inter­cos­tal ­space at mid­ax­il­lary ­line was eval­u­at­ed ret­ro­spec­tive­ly in chil­dren.
Methods. Ninety-sev­en chil­dren ­with pneu­moth­o­rax, treat­ed by ­tube thor­a­cos­to­my ­were tak­en ­into the ­study. There ­were 67 ­male and 30 ­female ­patients ­with a ­mean age of 6.5 ­years (­range 1 ­days to 15 ­years)
Results. Pneumothorax was locat­ed at the ­right ­side in 50 (51.5%), and at the ­left in 38 (39.1%) of the cas­es. Bilateral pneu­moth­o­rax was ­found in 9 addi­tion­al ­patients (9.2%). All ­patients ­were treat­ed ­with ­tube thor­a­cos­to­my ­placed in the pleu­ral cav­ity at the ­sixth inter­cos­tal ­space at the mid-axil­lary ­line. Postoperative ­course was unevent­ful and no com­pli­ca­tion was encoun­tered at any of the ­patients.
Conclusions. On the ­basis of ­these ­data we sug­gest ­that all thor­a­cos­to­my ­tubes ­should be insert­ed on the ­sixth inter­cos­tal ­space ­where ­both air and the accu­mu­lat­ing ­fluid can be ­reached. The inser­tion of the thor­a­cos­to­my ­tube at the sec­ond inter­cos­tal ­space ­must be avoid­ed ­since it car­ries a ­high ­risk of sub­cla­vian ­vein inju­ry in ­small chil­dren, and ­also a sec­on­dary ­tube is fre­quent­ly ­required to ­drain the accom­pa­ny­ing intra­pleu­ral ­fluid.

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