Abstract | BACKGROUND AND PURPOSE: The appropriate type of intervention for the treatment of empyema in children remains controversial. This study analyzed whether video-assisted thoracoscopic debridement (VATD) as first-line treatment is effective in the management of pediatric parapneumonic empyema. METHODS: We retrospectively reviewed the medical and microbiological records of pediatric patients with parapneumonic empyema diagnosed at a medical center from January 1995 to December 2002. The 55 patients included in this study were initially treated with either tube thoracostomy drainage (TTD group [n = 37]) or video-assisted thoracoscopic debridement (VATD group [n = 18]). RESULTS: A comparative analysis found no significant difference in patient characteristics between these 2 groups. Patients in the VATD group had a significantly shorter duration of fever (18.9 +/- 1.7 vs 26.9 +/- 1.3 days), chest tube placement (5.3 +/- 0.7 vs 15.2 +/- 2.0 days), antibiotic therapy after the procedure (12.2 +/- 1.0 vs 26.3 +/- 2.8 days), and hospital stay (21.5 +/- 2.1 vs 33.2 +/- 2.8 days). No additional procedures were required in the VATD group, whereas 65% (24/37) of patients in the TTD group underwent salvage VATD. CONCLUSION: Primary management using video-assisted thoracoscopic decortication was more effective and reduced the duration of illness in pediatric patients with parapneumonic empyema.
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Authors | Chien-Yi Chen, Jin-Shing Chen, Li-Min Huang, Ping-Ing Lee, Chung-Yi Lu, Yung-Chie Lee, Frank Leigh Lu |
Journal | Journal of the Formosan Medical Association = Taiwan yi zhi
(J Formos Med Assoc)
Vol. 102
Issue 12
Pg. 845-50
(Dec 2003)
ISSN: 0929-6646 [Print] Singapore |
PMID | 14976563
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Adolescent
- Child
- Child, Preschool
- Debridement
(methods)
- Drainage
(methods)
- Empyema, Pleural
(therapy)
- Female
- Humans
- Infant
- Male
- Retrospective Studies
- Thoracoscopy
(methods)
- Thoracostomy
- Treatment Outcome
- Video-Assisted Surgery
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