Related Experiment Videos
Video-assisted thoracoscopic surgery in the management of pediatric empyema
1Department of Surgery, Westchester County Medical Center, New York Medical College, Valhalla, USA.
Insights
Video-assisted thoracoscopic surgery (VATS) is a safe and effective treatment for pediatric empyema. This minimally invasive approach offers successful outcomes for children with multiloculated empyemas, avoiding prolonged hospital stays.
Area of Science:
- Pediatric Thoracic Surgery
- Minimally Invasive Procedures
Background:
- Empyema management in children has evolved from open thoracotomy to VATS.
- Multiloculated empyemas present a surgical challenge in pediatric patients.
Purpose of the Study:
- To evaluate the efficacy and safety of VATS for treating multiloculated empyemas in children.
Main Methods:
- Nine children with multiloculated empyema underwent VATS.
- Procedures included drainage, decortication, and chest tube placement under direct vision.
- Patients were treated between January 1994 and November 1996.
Main Results:
- VATS was successful in all nine pediatric patients.
- Average operating time was 120 minutes with minimal blood loss.
- All patients recovered well with no recurrences observed.
Conclusions:
- VATS is a safe and effective treatment for pediatric empyema.
- VATS reduces hospitalization, antibiotic duration, and patient discomfort.
- An algorithm for VATS in pediatric empyema management was established.
Background:
Management of empyema in children has progressed from open thoracotomy to video-assisted thoracoscopic surgery (VATS). The purpose of the present study was to evaluate the efficacy and safety of VATS in children with multiloculated empyemas.
Methods:
Nine children (mean age, 4 years; range, 21 months to 13 years) with empyema, in whom multiple loculations were found on computed tomography, were treated with VATS from January, 1994, to November, 1996. All patients underwent VATS under general anesthesia, with drainage of the empyemas, decortication, and placement of chest tubes under direct vision.
Results:
In all nine patients, VATS was successful. Average operating time was 120 minutes. Blood loss was insignificant, except in one patient who needed an intraoperative blood transfusion. This child required extensive decortication, with blood oozing from raw areas. All patients recovered well, with no recurrences to date. An algorithm for the use of VATS in the treatment plan for children with empyema was established.
Conclusion:
VATS provides safe and effective treatment in the management of pediatric empyema. Moreover, it avoids lengthy hospitalization, prolonged intravenous antibiotic therapy, and unnecessary pain and stress secondary to placement of chest tubes without anesthesia.