Thoracoscopy in the management of pediatric empyemas

Lamas-Pinheiro, Rúben; Henriques‐Coelho, Tiago; Fernandes, Sara; Correia, F.; Ferraz, Catarina; Guedes-Vaz, L.; Azevedo, Inês; Estevão‐Costa, José

doi:10.1016/j.rppnen.2015.12.004

Cited by 9 publications

(13 citation statements)

References 20 publications

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“…Overall effectiveness of VATS in this study was 95.2% which is a rate within the range reported in the literature. 1,2,[4][5][6] The main limitation of this study is its retrospective character, although we have implemented multiple plausibility checks and cross-validations in our data collection tool. Also, due to the fact that empyema is a not very common condition in pediatric patients there is a relatively small number of patients included in the study.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Nowadays, thoracic empyema occurs in 1 of 150 children hospitalized with pneumonia. 4 Because of increased incidence of pediatric empyema, physicians who treat children with thoracic empyema are forced to deal with the complex management of these patients. Antibiotics are an important adjunct in the treatment of empyemas, but it must be emphasized that drainage is the primary treatment modality.…”

Section: Introductionmentioning

confidence: 99%

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Video-Assisted Thoracic Surgery in Early Stage of Pediatric Pleural Empyema Improves Outcome

Pogorelić

Bjelanović

Gudelj

et al. 2020

Thorac Cardiovasc Surg

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Objectives The aim of this study was to observe outcomes of early decortication in a treatment of pleural empyema using video-assisted thoracoscopic surgery (VATS). Methods The case records of 21 pediatric patients who underwent VATS for empyema between 2009 and 2019 were retrospectively reviewed. Patients were observed based on demographic, laboratory, and clinical data, as well as treatment outcomes. Results Out of a total of 59 patients treated for pleural empyema, 21 (10 male and 11 female) children with a median age of 5 years (interquartile range [IQR] 2.8; 6.0) received VATS. The empyema was classified as stage I in 2 patients (9.5%), stage II in 4 patients (19%), and stage III in 15 patients (71.5%). Median surgical time was 60 minutes (IQR 50; 90). There were 2 (9.5%) postoperative complications and 1 recurrence (4.8%). Children treated in stages I and II showed significantly better postoperative results compared with the children treated in stage III. Length of hospital stay (8 vs. 10 days; p = 0.01), length of intensive care unit stay (1 vs. 5 days; p < 0.001), duration of chest tube drainage (4 vs. 6 days; p = 0.043), duration of postoperative fever (1.5 vs. 4 days; p = 0.001), and surgical time (40 vs. 70 minutes; p < 0.001) were significantly shorter in children operated in stages I and II than in stage III. Conclusion Early decortication using a VATS is a successful, effective, and easily performed surgical method in the treatment of pediatric pleural empyema, as well as a method that significantly improves recovery time and shortens the hospital stay.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Video-Assisted Thoracic Surgery in Early Stage of Pediatric Pleural Empyema Improves Outcome

Pogorelić

Bjelanović

Gudelj

et al. 2020

Thorac Cardiovasc Surg

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“…In his study, empyema was majorly noticed on right side of the lung (54%) compared to left side (42%) and in 4% cases empyema was seen in both sides of the lungs. 10 Conversion rates from thoracoscopy to thoracotomy are quite different among studies, ranging from 5.6% to 61%. 11 In present study, thoracoscopy was succeeded in 80% of the cases and the conversion rate to thoracotomy was only 20%.…”

Section: Discussionmentioning

confidence: 99%

“…This was similar to the findings of Lamas-Pinheiro et al (18%) and Landreneau et al (17%). 10,12 Postoperative hospital duration stays in patients who underwent thoracoscopy was between 1-10 days (mean-5 days) whereas in case of thoracotomy it was more than 11 days. In a study by Hornick et al the average number of postoperative hospital stays for patients who underwent thoracoscopy was 7.8 days, and in a study by Striffeler et al it was 12.3 days.…”

Section: Discussionmentioning

confidence: 99%

Prospective study of thoracoscopy in empyema patients

2018

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Background: Empyema thoracis is a serious problem from centuries, still causes significant morbidity and mortality if not diagnosed in early stages. The present study was conducted with the aim to evaluate the role of video assisted thoracoscopic surgery (VATS) in its management.Methods: This prospective study was done on 15 patients in the department of General Surgery, Govt. Medical College and Sir Thakhatsinhji Hospital Bhavnagar, from August 2011 to August 2012. The demographic data, clinical presentation, etiology, and management were recorded and analyzed.Results: None of the patients were observed with bronchopleural fistula. Majority of the patients were affected in the age group of 1-14 years (53%). Empyema was seen on left side of the lungs (73%). Etilogy of empyema was tuberculosis in 66% of the patients. Chest pain and breathlessness was seen in all in the patients (100%). No mortality was noticed in the study. The mean postoperative hospital stay was 5 days.Conclusions: Present study shows that VATS is feasible, safe and it is an efficient procedure with decrease hospital stay and minimal complications in the management of empyema thoracis in all age groups.

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“…Most pediatric VATS is carried out using three to five working ports. [1][2][3][4][5] The author started using only one working port for neonatal VATS in 2008 and was able to perform all VATS cases using one, or a maximum of two working ports in the last 10 years. The author coined the term port-less technique (PLT) to describe the use of minimal number of working ports or trocars in pediatric minimally invasive surgery(MIS)including VATS.…”

Section: Introductionmentioning

confidence: 99%

<p>Port-less technique (PLT) in pediatric video-assisted thoracoscopic surgery (VATS): a 10-year experience at National University of Malaysia</p>

Aziz¹,

Osman²,

Abdullah³

et al. 2019

OAS

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Background: In pediatric patients, video-assisted thoracoscopic surgery (VATS) is usually carried out using three to five working ports. The port-less technique (PLT) means only one or two ports are used; in most cases only the telescope would require a port. At our center, the VATS services were started in 2008, initially using the standard three-ports technique but shortly after this was replaced with PLT for all neonatal and pediatric VATS. The rationale of doing PLT was so that working instruments could move easier in the pediatric thoracic cavity. Furthermore, budget constraints did not allow us to purchase trocars of different sizes. Patients and methods: A review of all PLT cases was carried out at our institution from January 2008 to September 2018. We documented the diagnosis and type of surgery performed, age at surgery, number of ports used, conversion rate, morbidity and mortality as well as gross chest wall growth. Results: A total of 46 PLT cases were carried out; 16 were in neonates (34.7%). Conversion to thoracotomy occurred in five patients (10.8%). Diagnosis ranged from congenital anomalies like esophageal atresia to infective cause like empyema thoracis. Immediate morbidity occurred in four patients (8.7%) and there was one perioperative mortality (2.2%). The majority of PLTs (54%) were using two ports, and another 46% of PLTs were successfully carried out using one port. All neonatal and infant PLT cases were using one port (46%). Maximum follow-up was for 5 years and gross growth of chest wall was good. Conclusion: PLT is a feasible and safe technique for a variety of cases for neonatal and pediatric surgical intrathoracic pathology. We recommend PLT for all neonatal and pediatric VATS.

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Thoracoscopy in the management of pediatric empyemas

Cited by 9 publications

References 20 publications

Video-Assisted Thoracic Surgery in Early Stage of Pediatric Pleural Empyema Improves Outcome

Video-Assisted Thoracic Surgery in Early Stage of Pediatric Pleural Empyema Improves Outcome

Prospective study of thoracoscopy in empyema patients

<p>Port-less technique (PLT) in pediatric video-assisted thoracoscopic surgery (VATS): a 10-year experience at National University of Malaysia</p>

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