EFFICACY OF VIDEO-ASSISTED THORACOSCOPIC SURGERY (VATS) IN CHILDREN WITH EARLY EMPYEMA THORACIS IN COMPARISON TO OPEN THORACOTOMY

Background/Purpose: VATS is more effective in early empyema which includes exudative and early fibrinopurulent phase.This study evaluates the role of VATS and compares the results with open decortication cases done during the same period for early empyema thoracis. Method: A prospective study was done on children with empyema thoracis who underwent VATS from March 2017 to March 2020 in a single large center. The collected data included age, clinical presentation, radiological investigation, pleural fluid analysis, intraoperative findings,histopathological findings and post operative course.The length of stay and the post-operative time taken for clinical and radiological lung expansion was compared with cases of open decortication done for early empyema during the same period of study Results: Of the198 cases of empyema, 54 cases underwent VATS and open decortication was done in 130 children.Postoperatively patients became afebrile in 2 ± 1.2 days in VATS and 7 ± 3.2 days in open decortication.Clinical and radiological expansion was earlier in VATS with 3 ± 2.1 and 6 ± 2.2 days respectively. Conclusions: The prospective study concludes that VATS is more effective and less invasive than open thoracotomy for early empyema thoracis in decreasing the morbidity and has better cosmesis.