Efficacy, safety, and usefulness of uniportal video-assisted thoracoscopic surgery (VATS) for decortication of empyema in paediatric patients

Abstract

Objective: To determine the efficacy, safety, and usefulness of uniportal video-assisted thoracoscopic surgery (VATS) for decortication of empyema in paediatric patients. Study design: Case series Place & Duration of Study: Department of Cardiothoracic Surgery, Shifa International Hospital Islamabad, from September 2023 to May 2024. Patients and Methods: This study was carried out on patients who were admitted with post-pneumonic pleural effusion, for whom decortication of empyema was suggested, and uniportal video-assisted thoracoscopic surgery was performed. Results: A total of 7 patients with empyema thoracis  underwent Uni-VATS. In all patients of empyema thoracis who underwent thoracoscopic decortication, surgery was performed successfully, and none of them converted to open thoracotomy. MRSA was the most predominant organism found in the blood culture of our patients. The postoperative hospital stay was relatively brief averaging around 5 days, and placement of chest drains was for a shorter period with minimal output. The long-term outcome was excellent with all the patients healthy without any recurrence. Conclusions: Uniportal VATS is a safe, effective, and minimally invasive diagnostic and therapeutic procedure in children. It has a low rate of complications and is particularly useful for thoracoscopic decortication, which is the optimal procedure of choice for empyema thoracic. As the learning curve progresses, more and more procedures are being adopted via minimally invasive uniportal VATS, and it is becoming an increasingly popular option for paediatric patients with outstanding results.