Videothoracoscopic surgery before and after chest tube drainage for children with complicated parapneumonic effusion

Knebel, Rogério; Fraga, José Carlos Soares de; Amantéa, Sérgio L.; Isolan, Paola Maria Brolin Santis

doi:10.1016/j.jped.2017.05.008

Cited by 4 publications

(2 citation statements)

References 27 publications

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“…However, in the recent decades, studies published in literature showed how early surgery can guarantee a series of benefits, such as a reduction in hospital stay, fewer complications, and a faster recovery of respiratory function. Indeed, several studies in literature demonstrated the safety and efficacy of VATS in the treatment of PE in the pediatric population, observing how this approach is associated with a short recovery time, excellent aesthetic results, reduced post-operative pain and low complication rate [ 19 , 20 ].…”

Section: Video-assisted Thoracoscopymentioning

confidence: 99%

The role of the early video-assisted thoracoscopic surgery in children with pleural empyema

Di Mitri,

Thomas,

Capano

et al. 2024

Pediatr Surg Int

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Purpose Pleural empyema (PE) is a collection of purulent material in the pleural space. PE’s management in children is a challenge and an inappropriate diagnostic-therapeutic work up can lead to serious short and long-term complications. The aim of this study is to define the correct timing to approach a pediatric PE by video-assisted thoracoscopic surgery (VATS). Methods A retrospective observational study was conducted including pediatric patients who underwent video-assisted thoracoscopy for pleural empyema between May 2005 and September 2022. Results 62 patients were subjected to VATS for PE (32 in Group Early VATS, 30 in Group Late VATS). It emerged that the elapsed period between the onset of symptoms and surgery correlates in a statistically significant way with the post-operative stay in intensive care (z score 4.3 and p value < 0.0001) and the analysis between early VATS, late VATS and postoperative hospitalization showed a statistically significant reduction of the post-operative hospitalization in the early VATS groups (p value < 0.02). Conclusions VATS resulted to be safe and effective for the treatment of PE in children, and an early minimally invasive thoracoscopic intervention (early VATS) correlates with better outcomes, specifically in terms of intensive care hospitalization and overall hospitalization.

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Section: Video-assisted Thoracoscopymentioning

confidence: 99%

The role of the early video-assisted thoracoscopic surgery in children with pleural empyema

Di Mitri,

Thomas,

Capano

et al. 2024

Pediatr Surg Int

View full text Add to dashboard Cite

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“…(Gupta et al, 2018) Over time a big number of drugs have been developed against drug-resistant pathogens and some drugs are still developing. Reasonable use of antibiotics, starting with narrow spectrum drugs and the shortest possible duration may help in reducing the drug resistance (Arbo et al, 2019; Osowicki & Steer, 2019).Complications such as emphysema and lung abscess often need surgery procedures in addition to antibiotic treatment such as video-assisted thoracoscopy or insertion of percutaneous small-bore drainage with instillation of fibrinolytics(Arbo et al, 2019;Gupta et al, 2018;Haji et al, 2018;Knebel et al, 2018;Shan et al, 2019). Repeated ultrasounds may be required in the monitoring these patients, in the case of clinical deterioration as fluid may accumulate rapidly(Knebel et al, 2018;Williams et al, 2016).…”

mentioning

confidence: 99%

Difficulties in the Therapeutic Management of Complicated Pneumonia in Children

Miron¹,

Ivanov²,

Mocanu³

et al. 2023

The European Conference of Psychiatry and Mental Health "Galatia"

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Background: Pneumonia remains an important cause of morbidity and mortality at pediatric age (estimated by UNICEF at 3 million child deaths per year worldwide). Although the etiology of pneumonia is well known, in many patients the exact pathogen is not identified after routine diagnostic workup. We present three cases with complications. that were diagnosed and treated in our Pneumology Clinic. The aim of this case series is to point out the challenges in diagnosing and managing such diseases in children. The evolution of the three cases was difficult, all children needed ICU care. Cultures collected for all of them were negative, probably secondary to the fact that they received antibiotic treatment at home, before carrying out tests. Yet, after receiving broad-spectrum antibiotics and supportive treatment the evolution was favorable in the end. Conclusion: Despite progresses that were made in the last century concerning the antibiotic treatment in pneumonia there are still cases that develop severe complications that require multidisciplinary approach.

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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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Videothoracoscopic surgery before and after chest tube drainage for children with complicated parapneumonic effusion

Cited by 4 publications

References 27 publications

The role of the early video-assisted thoracoscopic surgery in children with pleural empyema

The role of the early video-assisted thoracoscopic surgery in children with pleural empyema

Difficulties in the Therapeutic Management of Complicated Pneumonia in Children

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

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