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Video-assisted thoracoscopic surgery of childhood empyema: early referral improves outcome.
MedLine Citation:
PMID:  20640576     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND/AIM: Video-assisted thoracoscopic surgery (VATS) is considered a safe and effective option in the treatment of childhood empyema. The aim of this study was to assess the efficacy of early referral for primary VATS in childhood empyema.
METHOD: A cohort of 24 consecutive children (12 boys, 12 girls) from 2004 to 2009 with post-pneumonic empyema, as demonstrated by loculation on ultrasound, undergoing VATS at a single tertiary level institution, was reviewed. All cases of empyema were managed as per the local protocol of early referral for primary VATS.
RESULTS: Mean age of presentation was 54 months (5 months to 15 years). Mean duration of symptoms before presentation to our centre was 6.29 days (±2.74 days) (range 1-10 days) and mean time to referral to the paediatric surgical unit was 1.95 days (±2.57 days). VATS was performed in all patients with a mean operating time 113.7 min (±37.0 min), which included time for bronchoscopy (range 43-184 min). The mean duration of chest drainage was 4 days (±2.96 days) and post-operative hospitalisation was 6.88 days (±4.11 days).
CONCLUSION: Early primary VATS for post-pneumonic empyema in children demonstrated a higher success rate, lower conversion to open thoracotomy improved outcome and shorter hospitalisation.
Authors:
Shanta Velaiutham; Sanjeeva Pathmanathan; Bruce Whitehead; Rajendra Kumar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric surgery international     Volume:  26     ISSN:  1437-9813     ISO Abbreviation:  Pediatr. Surg. Int.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8609169     Medline TA:  Pediatr Surg Int     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1031-5     Citation Subset:  IM    
Affiliation:
Department of Paediatric Surgery, John Hunter Children's Hospital, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW 2310, Australia.
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