June 2009. Volume 5. Number 2

Thoracoscopic decortication compared with thoracostomy with fibrinolysis in patients with empyema is more expensive and do not reduce hospitalization length

 
 
 
 
 
 
 
 
 
 
Rating: 0 (0 Votes)
Newsletter Free Subscription
Regularly recieve most recent articles by e-mail
Subscribe
Print
Add to library
Discuss this article

AVC | Critically appraised articles

St Peter SD, Tsao K, Harrison C, Jackson MA, Spilde TL, Keckler SJ, et al. Thoracoscopic decortication vs tube thoracostomy with fibrinolysis for empyema in children: a prospective, randomized trial. J Pediatr Surg. 2009;44:106-11
Reviewers: Ibáñez Pradas V1, Balaguer Santamaría A2.
1 Servicio de Cirugí­a Pediátrica, Hospital General de Castellón. Castellón. España.
2H General Catalunya. Sant Cugat del Vallés. Barcelona. España.
Correspondence: Vicente Ibáñez Pradas. Email: ibanez_vic@hotmail.com
Reception date: 30/04/2009
Acceptance date: 05/05/2009
Publication date: 01/06/2009

Abstract

Authors´ conclusions: video-thoracoscopy is the alternative therapy to fibrinolysis in patients with empyema. The results of this trial demonstrate that surgery as first option does not offer shorter hospitalization length or faster improvement of clinical parameters and, on the other hand, results in higher hospital charges.

Reviewers´ commentary: despite the lack of information in some aspects, this clinical trial confirms previous results. Therefore, surgery should be recommended only in cases of failure of fibrinolysis therapy

How to cite this article

Ibáñez Pradas V, Balaguer A. La decorticación toracoscópica es más cara y no reduce la estancia hospitalaria frente a la fibrinolisis para el tratamiento del empiema. Evid Pediatr. 2009;5:40

AVC | Critically appraised articles

St Peter SD, Tsao K, Harrison C, Jackson MA, Spilde TL, Keckler SJ, et al. Thoracoscopic decortication vs tube thoracostomy with fibrinolysis for empyema in children: a prospective, randomized trial. J Pediatr Surg. 2009;44:106-11
Reviewers: Ibáñez Pradas V1, Balaguer Santamaría A2.
1 Servicio de Cirugí­a Pediátrica, Hospital General de Castellón. Castellón. España.
2H General Catalunya. Sant Cugat del Vallés. Barcelona. España.
Correspondence: Vicente Ibáñez Pradas. Email: ibanez_vic@hotmail.com
Reception date: 30/04/2009
Acceptance date: 05/05/2009
Publication date: 01/06/2009

How to cite this article

Ibáñez Pradas V, Balaguer A. La decorticación toracoscópica es más cara y no reduce la estancia hospitalaria frente a la fibrinolisis para el tratamiento del empiema. Evid Pediatr. 2009;5:40

References

  1. Balfour-Lynn IM, Abrahamson E, Cohen G, Hartley J, King S, Parikh D, et al. Paediatric Pleural Diseases Subcommittee of the BTS Standards of Care Committee. BTS guidelines for the management of pleural infection in children. Thorax. 2005;60 Suppl 1:i1-21.
  2. Ochoa Sangrador C, Castro Rodríguez JA. Los empiemas paraneumónicos neumocócicos han aumentado tras la introducción de la vacuna neumocócica conjugada heptavalente. Evid Pediatr. 2006;2:31.
  3. Sonnappa S, Cohen G, Owens CM, van Doorn C , Cairns J , Stanojevic S , et al. Comparison of urokinase and video-assisted thoracoscopic surgery for treatment of childhood empyema. Am J Respir Crit Care Med. 2006;174:221-7.
  4. Coote N, Kay E. Surgical versus non-surgical management of pleural empyema. Cochrane Database Syst Rev. 2005;19;(4):CD001956.
  5. Wait MA, Sharma S, Hohn J, Dal Nogare A. A randomised trial of empyema therapy. Chest 1997;111:1548
01/06/2009

Linked Comment