The role of the early video-assisted thoracoscopic surgery in children with pleural empyema
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In brief
In brief
This retrospective study of 62 pediatric patients demonstrates that early video-assisted thoracoscopic surgery (VATS) for pleural empyema significantly reduces ICU stay and overall hospitalization compared to delayed intervention. The findings support early minimally invasive surgical management in children with empyema to optimize outcomes.
- Early VATS for pediatric pleural empyema significantly reduces ICU stay compared to delayed intervention (p<0.0001).
- Time from symptom onset to surgery directly correlates with post-operative ICU length of stay in pediatric empyema cases.
- Early minimally invasive thoracoscopic intervention reduces overall hospitalization duration (p<0.02) in children with PE.
- VATS is safe and effective for pediatric pleural empyema management across 17 years of experience (62 patients, 2005-2022).
- Prompt surgical intervention prevents progression to organized empyema, avoiding prolonged recovery and complications.
Written by the GCMD Library team from the article.
Abstract
Purpose
Pleural empyema (PE) is a collection of purulent material in the pleural space. PE’s management in children is a challenge and an inappropriate diagnostic-therapeutic work up can lead to serious short and long-term complications. The aim of this study is to define the correct timing to approach a pediatric PE by video-assisted thoracoscopic surgery (VATS).
Methods
A retrospective observational study was conducted including pediatric patients who underwent video-assisted thoracoscopy for pleural empyema between May 2005 and September 2022.
Results
62 patients were subjected to VATS for PE (32 in Group Early VATS, 30 in Group Late VATS). It emerged that the elapsed period between the onset of symptoms and surgery correlates in a statistically significant way with the post-operative stay in intensive care (z score 4.3 and p value < 0.0001) and the analysis between early VATS, late VATS and postoperative hospitalization showed a statistically significant reduction of the post-operative hospitalization in the early VATS groups (p value < 0.02).
Conclusions
VATS resulted to be safe and effective for the treatment of PE in children, and an early minimally invasive thoracoscopic intervention (early VATS) correlates with better outcomes, specifically in terms of intensive care hospitalization and overall hospitalization.