Korean J Thorac Cardiovasc Surg.  2019 Jun;52(3):125-130. 10.5090/kjtcs.2019.52.3.125.

Thoracotomy versus Video-Assisted Thoracoscopy in Pediatric Empyema

• Mohajerzadeh L
• Lotfollahzadeh S
• Vosoughi A
• Harirforoosh I
• Parsay S
• Amirifar H
• Farahbakhsh N
• Atqiaee K

• KMID: 2455155
• DOI: http://doi.org/10.5090/kjtcs.2019.52.3.125

Abstract

BACKGROUND
To compare the outcomes of video-assisted thoracoscopic surgery (VATS) in comparison to open thoracic surgery in pediatric patients suffering from empyema.
METHODS
A prospective study was carried out in 80 patients referred to the Department of Pediatric Surgery between 2015 and 2018. The patients were randomly divided into thoracotomy and VATS groups (groups I and II, respectively). Forty patients were in the thoracotomy group (16 males [40%], 24 females [60%]; average age, 5.77±4.08 years) and 40 patients were in the VATS group (18 males [45%], 22 females [55%]; average age, 6.27±3.67 years). There were no significant differences in age (p=0.61) or sex (p=0.26). Routine preliminary workups for all patients were ordered, and the patients were followed up for 90 days at regular intervals.
RESULTS
The average length of hospital stay (16.28±7.83 days vs. 15.83±9.44 days, p=0.04) and the duration of treatment needed for pain relief (10 days vs. 5 days, p=0.004) were longer in the thoracotomy group than in the VATS group. Thoracotomy patients had surgical wound infections in 27.3% of cases, whereas no cases of infection were reported in the VATS group (p=0.04).
CONCLUSION
Our results indicate that VATS was not only less invasive than thoracotomy, but also showed promising results, such as an earlier discharge from the hospital and fewer postoperative complications.

Keyword

Empyema; Video-assisted thoracic surgery; Thoracotomy

MeSH Terms

Empyema*
Female
Humans
Length of Stay
Male
Postoperative Complications
Prospective Studies
Surgical Wound Infection
Thoracic Surgery
Thoracic Surgery, Video-Assisted
Thoracoscopy*
Thoracotomy*