title: Thoracoscopic decortication: first-line therapy for pediatric empyema.
abstract: Video-assisted thoracoscopic surgery (VATS) has become a popular and well-refined procedure. It has several advantages over open thoracotomy in terms of invasiveness and cosmetics. The aim of this study is to consider if VATS can serve as primary management for pediatric empyema. Between October 2000 and December 2002, 13 children with empyema receiving VATS were retrospectively reviewed. Of them, 5 had tube thoracostomy before VATS intervention (group T), and 8 had VATS as the initial treatment (group V). Their mean (+/- SD) age of groups V and T were 5.75 +/- 4.43 and 4.0 +/- 1.58 years, respectively. The children of group V had a shorter length of hospital stay (group V 10.7 +/- 3.54 days; group T 28.2 +/- 8.32 days), a shorter period of chest tube drainage (group V 5 +/- 1.87 days; group T 25 +/- 11.08 days), less transfusion (group V 0.4 +/- 0.17 units; group T 0.9 +/- 0.27 units) and less radiation exposure (group V 10.3 +/- 3.49; group T 23.4 +/- 11.64). No mortality was noted in the entire series. We conclude that primary VATS is a safe, effective and definitive method which can serve as first-line therapy for children with empyema.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Y-T
authors.initials: YT
authors.lastname: Chang
authors.forename: Z-K
authors.initials: ZK
authors.lastname: Dai
authors.forename: E-L
authors.initials: EL
authors.lastname: Kao
authors.forename: S-H
authors.initials: SH
authors.lastname: Chou
authors.forename: Meei-Feng
authors.initials: MF
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D015505:Chest Tubes; D002648:Child; D002675:Child, Preschool; D004653:Empyema / Q000601:surgery*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D012189:Retrospective Studies; D013906:Thoracoscopy; D020535:Video-Assisted Surgery