CHIEN-YI CHENJIN-SHING CHENLI-MIN HUANGPING-ING LEECHUN-YI LULee Y.-C.FRANK LEIGH LU2020-12-082020-12-0820030929-6646https://www.scopus.com/inward/record.uri?eid=2-s2.0-2342465006&partnerID=40&md5=4da1dd2dbffafb9b1d25b7b6913c0bafhttps://scholars.lib.ntu.edu.tw/handle/123456789/524960Background and Purpose: The appropriate type of intervention for the treatment of empyema in children remains controversial. This study analyzed whether video-assisted thoracoscopic debridement (VATD) as first-line treatment is effective in the management of pediatric parapneumonic empyema. Methods: We retrospectively reviewed the medical and microbiological records of pediatric patients with parapneumonic empyema diagnosed at a medical center from January 1995 to December 2002. The 55 patients included in this study were initially treated with either tube thoracostomy drainage (TTD group [n = 37]) or video-assisted thoracoscopic debridement (VATD group [n = 18]). Results: A comparative analysis found no significant difference in patient characteristics between these 2 groups. Patients in the VATD group had a significantly shorter duration of fever (18.9±1.7 vs 26.9±1.3 days), chest tube placement (5.3±0.7 vs 15.2±2.0 days), antibiotic therapy after the procedure (12.2±1.0 vs 26.3±2.8 days), and hospital stay (21.5±2.1 vs 33.2±2.8 days). No additional procedures were required in the VATD group, whereas 65% (24/37) of patients in the TTD group underwent salvage VATD. Conclusion: Primary management using video-assisted thoracoscopic decortication was more effective and reduced the duration of illness in pediatric patients with parapneumonic empyema.[SDGs]SDG3antibiotic agent; child; child care; computer assisted tomography; controlled study; debridement; disease duration; empyema; female; fever; human; intermethod comparison; length of stay; major clinical study; male; medical record; microbiological examination; pneumonia; reoperation; retrospective study; review; Staphylococcus aureus; Staphylococcus epidermidis; Streptococcus; Streptococcus group A; Streptococcus group C; Streptococcus pneumoniae; thorax drainage; thorax radiography; thorax surgery; treatment outcome; tube; Adolescent; Child; Child, Preschool; Debridement; Drainage; Empyema, Pleural; Female; Humans; Infant; Male; Retrospective Studies; Thoracoscopy; Thoracostomy; Treatment Outcome; Video-Assisted Surgeryreview149765632-s2.0-2342465006