TY - JOUR T1 - Video-assisted thoracoscopic surgery (VATS) and percutaneous drain insertion (PDI) in childhood empyema JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P4117 AU - Iris De Schutter AU - Susanne van Steijn AU - Elke De Wachter AU - Jan Lamote AU - Dirk Smets AU - Patrick Haentjens AU - Anne Malfroot Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P4117.abstract N2 - Introduction:Pediatric parapneumonic effusion (PPE) incidence increases.Aims:To compare different treatment options in children with PPE.Methods:Retrospective analysis of children with PPE, admitted from 01/01/2007-30/11/2011. PPE definition: ≥1cm fluid on US or CT, and/or an opacity on chest X-ray of ≥50% of the hemithorax. Exclusion criteria: age <6m., trauma, thoracotomy.PDI and VATS were performed on clinical indication. VATS was reserved for patients (pts) with insufficient clinical improvement.Pts were treated as follows: Group A: no PDI/VATS. Group B: PDI. Group C: VATS. Group D: PDI followed by VATS.Results:49 pts were included, F/M=23/26, median age 3.3y (range 0.8-14.8y); 15, 12, 11, and 11, in group A, B, C, and D, resp. Age, sex ratio and inflammatory parameters were similar in all groups.Total length of stay (LOS) was similar for groups B, C and D, but shorter for group A (22 vs 18d, p=.023) Oxygen need was also shorter in group A compared to the others (4 vs 12d, p<.001). PDI was performed earlier than VATS (4 vs 9d, p=.011). Oxygen need and fever resolved earlier after intervention in group C than in group B (3 vs 8d, p=.009 and 1 vs 6d, p=.04, resp). Time to drain removal, LOS and duration of antibiotic treatment after intervention (3 vs 6d, p=.001; 11 vs 18d, p=.004; and 10 vs 18d, p=.001) were shorter in group C than in group B. ICU stay after intervention was similar in the 3 groups.Conclusions:VATS is a good treatment option for PDI in children with PPE. Clinical improvement was faster with VATS than with PDI, indicating that early performed VATS might shorten LOS and duration of antibiotic treatment. ER -