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Multicenter Study
. 2023 Nov 6;39(1):287.
doi: 10.1007/s00383-023-05566-z.

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

Alberto Ratta  1 , Francesca Nascimben  2 , Rossella Angotti  3 , Camilla Todesco  3 , Veronica Carlini  1 , Giulia Fusi  3 , Lorenzo De Biagi  1 , Simona Straziuso  1 , Francesco Italiano  1 , Vincenzo Domenichelli  1 , Mario Messina  3 , Francesco Molinaro  3
Affiliations
Multicenter Study

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

Alberto Ratta et al. Pediatr Surg Int. .

Abstract

Background: Both thoracic drainage and video-assisted thoracic surgery (VATS) are available treatment for pleural empyema in pediatric patients.

Materials and methods: This retrospective multicenter study includes pediatric patients affected by pleural empyema treated from 2004 to 2021 at two Italian centers. Patients were divided in G1 (traditional approach) and G2 (VATS). Demographic and recovery data, laboratory tests, imaging, surgical findings, post-operative management and follow-up were analyzed.

Results: 70 patients with a mean age of 4.8 years were included; 12 (17.1%) in G1 and 58 (82.9%) in G2. Median surgical time was 45 min in G1, 90 in G2 (p < 0.05). Mean duration of thoracic drainage was 7.3 days in G1, 6.2 in G2 (p > 0.05). Patients became afebrile after a mean of 6.4 days G1, 3.9 in G2 (p < 0.05). Mean duration of antibiotic therapy was 27.8 days in G1, 25 in G2 (p < 0.05). Mean duration of postoperative hospital stay was 16 days in G1, 12.1 in G2 (p < 0.05). There were 4 cases (33.3%) of postoperative complications in G1, 17 (29.3%) in G2 (p > 0.05). 2 (16.7%) patients of G1 needed a redosurgery with VATS, 1 (1.7%) in G2.

Conclusions: VATS is an effective and safe procedure in treatment of Pleural Empyema in children: it is associated to reduction of chest tube drainage, duration of fever, hospital stay, time of antibiotic therapy and recurrence rate.

Keywords: Children; Pleuric empyema; Thoracic drainage; Ultrasound; VATS.

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Conflict of interest statement

There are no prior publications with any overlapping information, including studies and patients. All the authors declare no financial relationships with a commercial entity producing health-related products and or services related to this article. No honorarium, grant, or other form of payment was given to anyone to write and to produce the manuscript. Each author saw and approved the submission of the manuscript.

Figures

Fig.1
Fig.1
Trend in prevalence of pleuric empyema in pediatric patients involved in the study
Fig. 2
Fig. 2
Comparison of outcomes between G1 and G2 groups in stage I
Fig. 3
Fig. 3
Comparison of outcomes between G1 and G2 groups in stage II
Fig. 4
Fig. 4
Comparison of outcomes between G1 and G2 groups in stage III
See this image and copyright information in PMC

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