Bishay, M; Short, M; Shah, K; Nagraj, S; Arul, S; Parikh, D; Jawaheer, G; (2009) Efficacy of video-assisted thoracoscopic surgery in managing childhood empyema: a large single-centre study. J PEDIATR SURG , 44 (2) 337 - 342. 10.1016/j.jpedsurg.2008.10.083.
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Background/Purpose: A randomised controlled trial evaluating the role of video-assisted thoracoscopic surgery (VATS) in childhood empyema reported a failure rate of 16.6%. Our aim is to determine the outcome Of VATS in a large series of children managed by 3 paediatric surgeons experienced in endoscopic surgeryMethod: A retrospective Study of all children with empyema admitted Under the care of the 3 surgeons between February 2004 and February 2009 was undertaken. Recorded details included demographic data, mode of presentation, preoperative investigations, operative details, antibiotic usage, micro-biological data, postoperative course, follow-up data and complications.Results: 114 children (69 boys, 45 girls) had VATS for empyema. Their median age was 5 (0.2-15) years. The pleural cavity was drained for a median of 4 (2-13) days. Median postoperative hospital stay was 7 (4-36) days. Median follow-Lip was 8 (1-24) months. There were 8 (7%) treatment failures: 5 conversions to thoracotomy and 3 recurrent empyemas. There were 7 complications (6%): air leak (n = 6) and lung injury (n = 1). 104 (91%) children had full resolution of symptoms. There were no deaths.Conclusion: Video-assisted thoracoscopic surgery has a better outcome in childhood empyema than reported in a recent randomised trial and it has an important role in the management of this condition. (C) 2009 Elsevier Inc. All rights reserved.
|Title:||Efficacy of video-assisted thoracoscopic surgery in managing childhood empyema: a large single-centre study|
|Keywords:||Empyema, Video-assisted thoracoscopic surgery, Children, PARAPNEUMONIC EFFUSIONS, PEDIATRIC EMPYEMA, INTRAPLEURAL STREPTOKINASE, PLEURAL INFECTION, CHILDREN, MANAGEMENT, UROKINASE, DEBRIDEMENT, DECORTICATION, THORACIS|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Child Health|
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