Thoracoscopy in Stage 3 empyema thoracis in children – A safe and feasible alternative to thoracotomy
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In brief
In brief
This prospective study demonstrates that VATS decortication is safe and feasible for Stage 3 empyema in children, with 74% completion rate and significantly shorter hospital stays compared to conversion to thoracotomy. The findings support minimally invasive approaches even in advanced pediatric empyema cases.
Written by the GCMD Library team from the article.
Background
Even though the role of thoracoscopy is well defined in Stage 2 empyema thoracis and is very popular, its role in the management of advanced empyema is still unclear. The technical difficulties and the potential complications are the principal reasons for the hesitancy in attempting video assisted thoracoscopic surgery (VATS) in advanced stages.
Methods
We prospectively studied the safety, feasibility and effectiveness of VATS for decortication in Stage 3 empyema.
Results
In the 61 cases that we attempted VATS over the last 7 years, we could complete the procedure in 45 patients (73.77%). Four children among them required re-do procedure later for persistent problems. Conversion to thoracotomy was needed in 16 patients (26.23%). The post-operative hospital stay of patients who underwent primary VATS decortication was significantly less when compared to patients requiring conversion (p