Debate 2: Is the Management of Childhood Empyema Primarily Medical, or Surgical?
Abstract The management of empyema thoracis has changed in the past 1–2 decades with the advent of video-assisted thoracoscopy (VATS), the surgeon’s weapon and fibrinolytic agents, the physician’s weapon. Inappropriate use of either and inability to accept their failure in some cases cause prolonged morbidity in an unsuspecting patient. VATS has been shown to be very effective in stage 2 empyema and is associated with early amelioration of symptoms and early discharge from hospital. Open thoracotomy still plays an important role in the management of delayed and complicated cases of empyema and has always produced good results. Some complications seen by surgeons are related to previous interventions and delayed referral. Lung status plays an important role in post operative recovery. In patients requiring intervention, both medical and surgical options should be considered without bias early in the management and discussed with care-givers to give best outcome..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:90 |
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| Enthalten in: |
Indian journal of pediatrics - 90(2023), 9 vom: 15. Mai, Seite 915-919 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Menon, Prema [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Bronchopleural fistula |
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| Anmerkungen: |
© The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| doi: |
10.1007/s12098-023-04589-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a Abstract The management of empyema thoracis has changed in the past 1–2 decades with the advent of video-assisted thoracoscopy (VATS), the surgeon’s weapon and fibrinolytic agents, the physician’s weapon. Inappropriate use of either and inability to accept their failure in some cases cause prolonged morbidity in an unsuspecting patient. VATS has been shown to be very effective in stage 2 empyema and is associated with early amelioration of symptoms and early discharge from hospital. Open thoracotomy still plays an important role in the management of delayed and complicated cases of empyema and has always produced good results. Some complications seen by surgeons are related to previous interventions and delayed referral. Lung status plays an important role in post operative recovery. In patients requiring intervention, both medical and surgical options should be considered without bias early in the management and discussed with care-givers to give best outcome. | ||
| 650 | 4 | |a Bronchopleural fistula | |
| 650 | 4 | |a Decortication | |
| 650 | 4 | |a Pulmonary necrosis | |
| 650 | 4 | |a Thoracotomy | |
| 650 | 4 | |a Video-assisted thoracoscopy | |
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