Çocukluk Çağı İleri Evre Plevral Ampiyem Tedavisinde Torakoskopik Debridman Zamanlaması Ne Kadar Önemli?
Amaç: İleri evre plevral ampiyem (PA) tanısı ile torakoskopik debridman (TD) yapılan hastalarda, torakoskopi yapılma zamanının morbidite üzerine etkisinin değerlendirilmesi. Gereç ve Yöntem: Ocak 2010 ve Mart 2019 yılları arasında ileri evre PA tanısı alan hastalar semptom süresi, TD sonrası göğüs tüpü kalış süresi, hastanede kalış süresi, ek girişimler ve komplikasyonlar açısından geriye dönük olarak değerlendirildi. TD yapılan hastalarda semptom süresi ortancası hesaplandı. Semptom süresi bu değer ve altında olanlarla üstünde olan hastalar karşılaştırıldı. Veriler IBM SPSS programında analiz edildi. p
How Important is the Timing of Thoracoscopic Debridement in the Management of Advanced Pleural Empyema in Children?
Objective: To evaluate the relation between the timing of thoracoscopic debridement (TD) and morbidity in children with advanced pleural empyema (PA). Material and Method: The children managed for advanced stage PA between January 2010 and March 2019 were included. Additional interventions, complications, length of hospital stay and duration of symptoms and thoracic drainage were retrospectively evaluated. Patients were divided into 2 groups according to median duration of symptoms. Statistical analysis was performed by IBM SPSS software, p 10 days (Group2). Median length of stay was 10.5 days (4-26) in Group 1 and 20 days (4-56) in Group 2. These two parameters were significantly lower in Group 1 (p
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- 1. Griffith D, Boal M, Rogers T. Evolution of practice in the management of parapneumonic effusion and empyema in children. J Pediatr Surg 2018; 53: 644-6.
- 2. Tsujimoto N, Saraya T, Light RW et al. A simple method for differentiating complicated parapneumonic effusion/empyema from parapneumonic effusion using the split pleura sign and the amount of pleural effusion on thoracic CT. PLoS One 2015; 10: e0130141.
- 3. Barglik R, Korlacki W, Grabowski A. Methods of treatment of pleural empyema in children. Pediatr Pol 2019; 94: 185-92.
- 4. Pacilli M, Nataraja RM. Management of paediatric empyema by video-assisted thoracoscopic surgery (VATS) versus chest drain with fibrinolysis: Systematic review and meta-analysis. Paediatr Respir Rev 2019; 30: 42-8.
- 5. Redden MD, Chin TY, van Driel ML. Surgical versus non-surgical management for pleural empyema. Cochrane Database Syst Rev 2017; 3: CD010651.
- 6. Dzielicki J, Korlacki W. The role of thoracoscopy in the treatment of pleural empyema in children. Surg Endosc 2006; 20: 1402-5.
- 7. Chung JH, Lee SH, Kim KT, Jung JS, Son HS, Sun K. Optimal timing of thoracoscopic drainage and decortication for empyema. Ann Thorac Surg 2014; 97: 224-9.
- 8. Klena JW, Cameron BH, Langer JC, Winthrop AL, Perez CR. Timing of video-assisted thoracoscopic debridement for pediatric empyema. J Am Coll Surg 1998; 187: 404-8.
- 9. Agarwal N, Taneja S, Saxena R, Verma A. Clinical profile, complications, morbidity and outcome of empyema thoracis in children in a tertiary care centre. Int J Contemp Pediatr 2018; 5: 967-72.
- 10. Santanakrishnan R, Murali GS, Javaregowda D, Shankar G, Babu N, Jadhav V. Thoracoscopy in stage 3 empyema thoracis in children - A safe and feasible alternative to thoracotomy. J Pediatr Surg 2020; 55: 756-60.
- 11. Andrews NC, Parker EF, Shaw RR et al. American Thoracic Society: Management of nontuberculous empyema. Am Resir Dis 1962; 85: 935-6.
- 12. Almaramhy HH, Allama AM. Indicators for surgical intervention in thoracic empyema in children. Saudi Med J 2015; 36: 1061-6.
- 13. Mehmetoğlu F, Kinaci E, Süer M. Çocuklarda postpnömonik ampiyem: Retrospektif, tek merkez çalışması. Zeynep Kamil Tıp Bülteni 2017; 48: 146-51.
- 14. Bender MT, Ward AN, Iocono JA, Saha SP. Current surgical management of empyema thoracis in children: A single-center experience. Am Surg 2015; 81: 849-53.
- 15. Touray S, Sood RN, Lindstrom D et al. Risk stratification in patients with complicated parapneumonic effusions and empyema using the RAPID score. Lung 2018; 196: 623-9.
- 16. Tander B, Ustun L, Ariturk E, Rizalar R, Ayyildiz SH, Bernay F. Balloon-assisted single-port thoracoscopic debridement in children with thoracic empyema. J Laparoendosc Adv Surg Tech A 2007; 17: 504-8.
- 17. Bouros D, Antoniou KM, Chalkiadakis G, Drositis J, Petrakis I, Siafakas N. The role of video-assisted thoracoscopic surgery in the treatment of parapneumonic empyema after the failure of fibrinolytics. Surg Endosc 2002; 16: 151-4.
- 18. Shirota C, Uchida H. Initial treatment of septated parapneumonic empyema with drainage plus fibrinolytic agents is equally effective as video-assisted thoracoscopic surgery, and is suitable as first-line therapy. Transl Pediatr 2015; 4: 41-4.
- 19. Pan H, He J, Shen J, Jiang L, Liang W He J. A meta-analysis of video-assisted thoracoscopic decortication versus open thoracotomy decortication for patients with empyema. J Thorac Dis 2017; 9: 2006-14.
- 20. Sokouti M, Sadeghi R, Pashazadeh S et al. Treating empyema thoracis using video-assisted thoracoscopic surgery and open decortication procedures: a systematic review and meta-analysis by meta-mums tool. Arch Med Sci 2019; 15: 912-35.
- 21. Kalfa N, Allal H, Montes-Tapia F et al. Ideal timing of thoracoscopic decortication and drainage for empyema in children. Surg Endosc 2004; 18: 472-7.