Pleural drainage vs video-assisted thoracoscopic debridement in children affected by pleural empyema
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Nov 2023 · 1 min read
In brief
In brief
This multicenter retrospective study compared traditional chest tube drainage versus VATS debridement in 70 pediatric empyema patients. VATS demonstrated superior outcomes including shorter fever duration, reduced hospital stay, and lower reintervention rates, supporting its use as preferred treatment in children with pleural empyema.
Written by the GCMD Library team from the article.
Abstract
Background
Both thoracic drainage and video-assisted thoracic surgery (VATS) are available treatment for pleural empyema in pediatric patients.
Materials and methods
This retrospective multicenter study includes pediatric patients affected by pleural empyema treated from 2004 to 2021 at two Italian centers. Patients were divided in G1 (traditional approach) and G2 (VATS). Demographic and recovery data, laboratory tests, imaging, surgical findings, post-operative management and follow-up were analyzed.
Results
70 patients with a mean age of 4.8 years were included; 12 (17.1%) in G1 and 58 (82.9%) in G2. Median surgical time was 45 min in G1, 90 in G2 (p < 0.05). Mean duration of thoracic drainage was 7.3 days in G1, 6.2 in G2 (p > 0.05). Patients became afebrile after a mean of 6.4 days G1, 3.9 in G2 (p < 0.05). Mean duration of antibiotic therapy was 27.8 days in G1, 25 in G2 (p < 0.05). Mean duration of postoperative hospital stay was 16 days in G1, 12.1 in G2 (p < 0.05). There were 4 cases (33.3%) of postoperative complications in G1, 17 (29.3%) in G2 (p > 0.05). 2 (16.7%) patients of G1 needed a redosurgery with VATS, 1 (1.7%) in G2.
Conclusions
VATS is an effective and safe procedure in treatment of Pleural Empyema in children: it is associated to reduction of chest tube drainage, duration of fever, hospital stay, time of antibiotic therapy and recurrence rate.