- 期刊
Favorable Outcome of Parapneumonic Empyema in Children Managed by Primary Video-Assisted Thoracoscopic Debridement
以內視胸腔鏡作為兒童膿胸第一線治療之成效
並列摘要
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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