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Pleural drainage vs video-assisted thoracoscopic debridement in children affected by pleural empyema

Alberto Ratta1, Francesca Nascimben2, Rossella Angotti3

  • 1Pediatric Surgery Unit, Infermi Hospital, AUSL Romagna, Rimini, Italy.

Pediatric Surgery International
|November 5, 2023
PubMed

Insights

Video-assisted thoracic surgery (VATS) is a safe and effective treatment for pediatric pleural empyema. This approach reduces chest tube drainage, fever duration, hospital stay, and antibiotic therapy time.

Area of Science:

  • Pediatric Thoracic Surgery
  • Minimally Invasive Surgery
  • Infectious Diseases

Background:

  • Pleural empyema is a significant thoracic infection in children.
  • Traditional open drainage and video-assisted thoracic surgery (VATS) are established treatment options.

Purpose of the Study:

  • To compare the efficacy and safety of VATS versus traditional thoracic drainage for pediatric pleural empyema.
  • To analyze outcomes including recovery time, complications, and recurrence rates.

Main Methods:

  • Retrospective multicenter study of pediatric patients with pleural empyema (2004-2021).
  • Patients were divided into traditional approach (G1) and VATS (G2) groups.
  • Analysis of demographic, clinical, imaging, surgical, and follow-up data.

Main Results:

  • VATS (G2) showed significantly shorter durations for fever resolution (3.9 vs. 6.4 days) and hospital stay (12.1 vs. 16 days) compared to the traditional approach (G1).
  • Antibiotic therapy duration was also reduced with VATS (25 vs. 27.8 days).
  • While complication rates were similar (29.3% G2 vs. 33.3% G1), VATS had a lower re-operation rate (1.7% vs. 16.7%).

Conclusions:

  • VATS is a safe and effective treatment for pediatric pleural empyema.
  • VATS is associated with improved clinical outcomes, including reduced fever, shorter hospital stays, and less need for re-operation.
  • VATS offers advantages over traditional drainage in managing pediatric pleural empyema.
Abstract

Keywords:
ChildrenPleuric empyemaThoracic drainageUltrasoundVATS

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