Comparison of the Methods of Fibrinolysis by Tube Thoracostomy and Thoracoscopic Decortication in Children With Stage Ii and Iii Empyema: a Prospective Randomized Study

dc.contributor.author Cobanoglu, Ufuk
dc.contributor.author Sayir, Fuat
dc.contributor.author Bilici, Salim
dc.contributor.author Melek, Mehmet
dc.date.accessioned 2025-05-10T16:49:07Z
dc.date.available 2025-05-10T16:49:07Z
dc.date.issued 2011
dc.department T.C. Van Yüzüncü Yıl Üniversitesi en_US
dc.department-temp [Cobanoglu, Ufuk; Sayir, Fuat; Bilici, Salim; Melek, Mehmet] Van State Hosp, Dept Thorac Surg, Van, Turkey en_US
dc.description.abstract Today, in spite of the developments in imaging methods and antibiotherapy childhood pleural empyema is a prominent cause of morbidity and mortality. In recent years it has been shown that there has been an increase in the frequency of pleural empyema in children, and antibiotic resistance in microorganisms causing pleural empyema has made treatment difficult. Despite the many studies investigating thoracoscopic debridement and fibrinolytic treatment separately in the management of this disease, there is are not enough studies comparing these two treatments. The aim of this study was to prospectively compare the efficacy of two different treatment methods in stage II and III empyema cases and to present a perspective for treatment options. We excluded from the study cases with: i) thoracoscopic intervention and fibrinolytic agent were contraindicated; ii) immunosup pression or additional infection focus; iii) concomitant diseases, those with bronchopleural fistula diagnosed radiologically, and Stage I cases. This gave a total of 54 cases: 23 (42.6%) in stage II, and 31 (574%) cases in stage III. These patients were randomized into two groups of 27 cases each for debridement or fibrinolytic agent application by video-assisted thoracoscopic decortication (VATS). The continuity of symptoms after the operation, duration of thoracic tube in situ, and the length of hospital stay, in the VATS group were of significantly, shorter duration than in the streptokinase applications (P=0.0001). In 19 of 27 cases (70.37%) in which fibrinolytic treatment was applied and in 21 cases of 27 (77.77%) in which VATS was applied, the lung was fully expanded and the procedure was considered successful. There was no significant difference with respect to success rates between the two groups (P-0.533). The complication rate in our cases was 12.96% and no mortality was observed. Similar success rates in thoracoscopic drainage and enzymatic debridement, and the low cost of enzymatic drainage both served to highlight intrapleural streptokinase treatment as a reliable method in reducing the need for surgery in complicated empyema. en_US
dc.description.woscitationindex Emerging Sources Citation Index
dc.identifier.doi 10.4081/pr.2011.e29
dc.identifier.endpage 118 en_US
dc.identifier.issn 2036-749X
dc.identifier.issn 2036-7503
dc.identifier.issue 4 en_US
dc.identifier.pmid 22355514
dc.identifier.scopusquality Q3
dc.identifier.startpage 114 en_US
dc.identifier.uri https://doi.org/10.4081/pr.2011.e29
dc.identifier.uri https://hdl.handle.net/20.500.14720/1735
dc.identifier.volume 3 en_US
dc.identifier.wos WOS:000216544500004
dc.identifier.wosquality N/A
dc.language.iso en en_US
dc.publisher Pagepress Publ en_US
dc.relation.publicationcategory Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı en_US
dc.rights info:eu-repo/semantics/openAccess en_US
dc.subject Child en_US
dc.subject Empyema en_US
dc.subject Fibrinolysis en_US
dc.subject Thoracoscopic Decortication en_US
dc.title Comparison of the Methods of Fibrinolysis by Tube Thoracostomy and Thoracoscopic Decortication in Children With Stage Ii and Iii Empyema: a Prospective Randomized Study en_US
dc.type Article en_US
dspace.entity.type Publication

Files