Utilizing VATS in The Management of Pediatric Empyema Thoracis: A Study at A Tertiary Care Hospital in Guntur

Abstract

Empyema thoracis can produce significant morbidity in children if inadequately treated. Correct evaluation of the stage
of the disease, the clinical condition of the child, and proper assessment of the response to conservative treatment is crucial in
deciding the mode of further surgical intervention. The present hospital-based observational study was conducted in the
Department of Cardiovascular and Thoracic Surgery, Government General Hospital, Guntur Medical College, Guntur. The study
period was from August 2017 to May 2022. Chest X-ray and Axial non-contrast computerized tomography (CT) scans were done
in all the patients. All the patients underwent thoracoscopic decortication through Video-assisted Thoracoscopic Surgery (VATS)].
The total number of patients with pediatric empyema thoracis during the study period was 56. Of these, 36 were males and 20
were females, with the mean age being 5.6 ± 5.08 years. A surgical procedure was done under general anaesthesia and minimally
invasive thoracoscopic decortication. All patients had lung expansion on discharge chest x-ray. The mean number of days of
hospital stay was 4.8 ± 0.8 days with no hospital mortality. Decortication appears to be a useful definitive treatment for children
with empyema thoracis in developing countries. Decortication emerges as a promising and effective therapeutic strategy for
addressing empyema thoracis in pediatric cases within developing countries. This surgical procedure, involving the removal of the
infected membrane surrounding the lung, demonstrates its potential as a definitive solution. Particularly relevant in regions with
limited medical resources, decortication exhibits its utility by offering a comprehensive approach to managing this condition. By
alleviating the burden of empyema thoracis in young patients, decortication not only contributes to improved health outcomes
but also showcases its significance as a valuable intervention in the context of healthcare disparities across developing nations.