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Updated: Aug 12, 2026

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
05:50

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

Published on: March 12, 2020

Thoracoscopic management of empyema in children

A M Davidoff1, A Hebra, J Kerr

  • 1Department of Pediatric Surgery, University of Pennsylvania School of Medicine, Philadelphia, USA.

Journal of Laparoendoscopic Surgery
|March 1, 1996
PubMed

Insights

Video-assisted thoracoscopic surgery offers a minimally invasive approach for pediatric empyema management. This technique shows promise in effectively treating empyema in children, potentially reducing complications associated with traditional open surgeries.

Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Minimally Invasive Procedures

Background:

  • Management of pediatric empyema remains controversial.
  • Traditional surgical interventions like thoracotomy can lead to significant morbidity.
  • Previous attempts at closed tube thoracostomy may be unsuccessful.

Purpose of the Study:

  • To evaluate the effectiveness of video-assisted thoracoscopic adhesiolysis and pleural debridement in treating pediatric empyema.
  • To compare thoracoscopic drainage with traditional surgical methods.

Main Methods:

  • Nine children with postpneumonic empyema underwent thoracoscopic drainage after failed tube thoracostomy.
  • Procedures were performed within the past two years.
  • Data on treatment success, complications, and recovery time were collected.

Main Results:

  • Seven out of nine patients were successfully treated with thoracoscopic surgery without further intervention.
  • Procedures were technically easier when performed during the early fibrinopurulent stage.
  • Average chest tube removal time was 8.5 days.
  • One immunocompromised patient and one with coagulopathy required subsequent open procedures.

Conclusions:

  • Video-assisted thoracoscopic adhesiolysis and pleural debridement are effective treatment options for pediatric empyema.
  • This minimally invasive approach offers improved visualization, debridement, and drainage.
  • Subjectively diminished postoperative pain and morbidity were noted.

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