$Uniportal Thoracoscopic Debridement for Children With Refractory Pleural Empyema: Case Series of 21 Patients$
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Uniportal Thoracoscopic Debridement for Children With Refractory Pleural Empyema: Case Series of 21 Patients

Purpose: The effectiveness of video-assisted thoracic surgery (VATS), even uniportal VATS (U-VATS), in the treatment of pleural empyema has recently been demonstrated. However, few works have evaluated its safety and feasibility for children. We review our experience with U-VATS in the treatment of...

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Autores principales:	Jin-Xi Huang, Qiang Chen, Song-Ming Hong, Jun-Jie Hong, Hua Cao
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	video-assisted thoracoscopic surgery uniportal children pleural empyema pyothorax Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/413c240872e94875bfb4ff8c518622fe
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spelling	oai:doaj.org-article:413c240872e94875bfb4ff8c518622fe2021-11-30T18:49:33ZUniportal Thoracoscopic Debridement for Children With Refractory Pleural Empyema: Case Series of 21 Patients2296-236010.3389/fped.2021.777324https://doaj.org/article/413c240872e94875bfb4ff8c518622fe2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fped.2021.777324/fullhttps://doaj.org/toc/2296-2360Purpose: The effectiveness of video-assisted thoracic surgery (VATS), even uniportal VATS (U-VATS), in the treatment of pleural empyema has recently been demonstrated. However, few works have evaluated its safety and feasibility for children. We review our experience with U-VATS in the treatment of pleural empyema for children under 11 years old.Methods: From January 2019 to December 2020, we consecutively enrolled 21 children with stage II and stage III pleural empyema in our institution. A 1.0 cm utility port was created in the 5th intercostal space at the anterior axillary line. A rigid 30°5 mm optic thoracoscope was used for vision, and two or three instruments were used through the port. Surgery was based on three therapeutic columns: removal of pleural fluid, debridement, and decortication. A chest tube was inserted through the same skin incision. Perioperative data and outcomes were summarized.Results: The procedures were successful, and satisfactory debridement of the pleural cavity was achieved in all cases. The mean age was 4.1 years (range: 6 months to 11 years old). The mean operating time was 65.7 ± 23.2 min. No intraoperative conversion or major complications were identified among the patients. The mean hospital stay was 5.0 ± 0.6 days. At a follow-up of more than 4 months after operating, all patients had recovered well without recurrence.Conclusion: According to our experience, U-VATS debridement is feasible for the surgical management of stage II and III empyema in the pediatric population. Indeed, U-VATS permits easier performance and complete debridement and decortication, with a very low risk for conversion.Jin-Xi HuangJin-Xi HuangJin-Xi HuangJin-Xi HuangQiang ChenQiang ChenQiang ChenQiang ChenSong-Ming HongSong-Ming HongSong-Ming HongSong-Ming HongJun-Jie HongJun-Jie HongJun-Jie HongJun-Jie HongHua CaoHua CaoHua CaoHua CaoFrontiers Media S.A.articlevideo-assisted thoracoscopic surgeryuniportalchildrenpleural empyemapyothoraxPediatricsRJ1-570ENFrontiers in Pediatrics, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	video-assisted thoracoscopic surgery uniportal children pleural empyema pyothorax Pediatrics RJ1-570
spellingShingle	video-assisted thoracoscopic surgery uniportal children pleural empyema pyothorax Pediatrics RJ1-570 Jin-Xi Huang Jin-Xi Huang Jin-Xi Huang Jin-Xi Huang Qiang Chen Qiang Chen Qiang Chen Qiang Chen Song-Ming Hong Song-Ming Hong Song-Ming Hong Song-Ming Hong Jun-Jie Hong Jun-Jie Hong Jun-Jie Hong Jun-Jie Hong Hua Cao Hua Cao Hua Cao Hua Cao Uniportal Thoracoscopic Debridement for Children With Refractory Pleural Empyema: Case Series of 21 Patients
description	Purpose: The effectiveness of video-assisted thoracic surgery (VATS), even uniportal VATS (U-VATS), in the treatment of pleural empyema has recently been demonstrated. However, few works have evaluated its safety and feasibility for children. We review our experience with U-VATS in the treatment of pleural empyema for children under 11 years old.Methods: From January 2019 to December 2020, we consecutively enrolled 21 children with stage II and stage III pleural empyema in our institution. A 1.0 cm utility port was created in the 5th intercostal space at the anterior axillary line. A rigid 30°5 mm optic thoracoscope was used for vision, and two or three instruments were used through the port. Surgery was based on three therapeutic columns: removal of pleural fluid, debridement, and decortication. A chest tube was inserted through the same skin incision. Perioperative data and outcomes were summarized.Results: The procedures were successful, and satisfactory debridement of the pleural cavity was achieved in all cases. The mean age was 4.1 years (range: 6 months to 11 years old). The mean operating time was 65.7 ± 23.2 min. No intraoperative conversion or major complications were identified among the patients. The mean hospital stay was 5.0 ± 0.6 days. At a follow-up of more than 4 months after operating, all patients had recovered well without recurrence.Conclusion: According to our experience, U-VATS debridement is feasible for the surgical management of stage II and III empyema in the pediatric population. Indeed, U-VATS permits easier performance and complete debridement and decortication, with a very low risk for conversion.
format	article
author	Jin-Xi Huang Jin-Xi Huang Jin-Xi Huang Jin-Xi Huang Qiang Chen Qiang Chen Qiang Chen Qiang Chen Song-Ming Hong Song-Ming Hong Song-Ming Hong Song-Ming Hong Jun-Jie Hong Jun-Jie Hong Jun-Jie Hong Jun-Jie Hong Hua Cao Hua Cao Hua Cao Hua Cao
author_facet	Jin-Xi Huang Jin-Xi Huang Jin-Xi Huang Jin-Xi Huang Qiang Chen Qiang Chen Qiang Chen Qiang Chen Song-Ming Hong Song-Ming Hong Song-Ming Hong Song-Ming Hong Jun-Jie Hong Jun-Jie Hong Jun-Jie Hong Jun-Jie Hong Hua Cao Hua Cao Hua Cao Hua Cao
author_sort	Jin-Xi Huang
title	Uniportal Thoracoscopic Debridement for Children With Refractory Pleural Empyema: Case Series of 21 Patients
title_short	Uniportal Thoracoscopic Debridement for Children With Refractory Pleural Empyema: Case Series of 21 Patients
title_full	Uniportal Thoracoscopic Debridement for Children With Refractory Pleural Empyema: Case Series of 21 Patients
title_fullStr	Uniportal Thoracoscopic Debridement for Children With Refractory Pleural Empyema: Case Series of 21 Patients
title_full_unstemmed	Uniportal Thoracoscopic Debridement for Children With Refractory Pleural Empyema: Case Series of 21 Patients
title_sort	uniportal thoracoscopic debridement for children with refractory pleural empyema: case series of 21 patients
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/413c240872e94875bfb4ff8c518622fe
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Uniportal Thoracoscopic Debridement for Children With Refractory Pleural Empyema: Case Series of 21 Patients

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