Thoracoscopy in Stage 3 empyema thoracis in children – A safe and feasible alternative to thoracotomy

Space: StayCurrentMD Author: Ramesh Santanakrishnan, Govindappa Saroja Murali, Deepak Javaregowda, Gowri Shankar, Narendra Babu, Vinay Jadhav Published:

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Ramesh Santanakrishnan, Govindappa Saroja Murali, Deepak Javaregowda, Gowri Shankar, Narendra Babu, Vinay Jadhav

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Abstract

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 

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