Annals of Thoracic Medicine
ORIGINAL ARTICLE
Year
: 2022  |  Volume : 17  |  Issue : 3  |  Page : 145--150

Fibrinolysis versus thoracoscopy: Comparison of results in empyema management in the child


Maria Rosa Ibarra Rodriguez, Jose Ignacio Garrido Pérez, Fernando Vázquez Rueda, Francisco Javier Murcia Pascual, Sandra Rocio Wiesner Torres, Rosa Maria Paredes Esteban 
 Department of Pediatric Surgery, Reina Sofia University Hospital, Córdoba, Spain

Correspondence Address:
Dr. Maria Rosa Ibarra Rodriguez
Department of Pediatric Surgery, Reina Sofia University Hospital, Av. Menéndez Pidal S/N CP 14004, Córdoba
Spain

OBJECTIVE: The objective of this study is to compare the outcome of treatment with drainage and urokinase (UK) versus thoracoscopy (TS) in pleural empyema secondary to complicated pneumonia. METHODS: This was a retrospective study of patients with complicated parapneumonic effusions between 2008 and 2019 treated with UK or TS. Epidemiological and evolutionary data compared days of fever, antibiotic, pre- and postprocedure stay, time to radiological resolution, and complications. The results were expressed as medians and the comparisons were made by the Mann–Whitney U-test. RESULTS: Of 143 patients with NC, 46 were empyemas (26 men), 25 were treated with TS, and 10 were treated with UK. The remaining 11 received combined treatment, being excluded from the study. There were no significant differences between TS versus UK in age (median 4 vs. 3 years), days of fever before the procedure (4 vs. 2) and after (2 vs. 2), days of antibiotic treatment before the procedure (4 vs. 4), overall hospital stay (15 vs. 13 days), and months until radiological normalization (2 vs. 2). The complications related to the therapy were scarce in both groups and had no impact on evolution. Patients with TS had a longer preprocedural stay (4 vs. 1; P < 0.001) and required fewer days of subsequent antibiotic after procedure (8 vs. 11; P = 0.03), and a shorter overall antibiotic treatment time (11 vs. 16; P = 0.03). They also had a shorter post-TS stay (9 vs. 12 days), although this difference did not become significant (P = 0.09). CONCLUSIONS: In our experience, the results obtained with both procedures are quite similar, although patients undergoing TS had a better evolution (fewer days of antibiotic and a tendency to less hospitalization), despite having been performed a priori in more evolved patients.


How to cite this article:
Ibarra Rodriguez MR, Garrido Pérez JI, Rueda FV, Murcia Pascual FJ, Wiesner Torres SR, Paredes Esteban RM. Fibrinolysis versus thoracoscopy: Comparison of results in empyema management in the child.Ann Thorac Med 2022;17:145-150


How to cite this URL:
Ibarra Rodriguez MR, Garrido Pérez JI, Rueda FV, Murcia Pascual FJ, Wiesner Torres SR, Paredes Esteban RM. Fibrinolysis versus thoracoscopy: Comparison of results in empyema management in the child. Ann Thorac Med [serial online] 2022 [cited 2022 Nov 29 ];17:145-150
Available from: https://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2022;volume=17;issue=3;spage=145;epage=150;aulast=Ibarra;type=0