Comparison of VATS and thoracotomy in the treatment of empyema thoracis in children: A retrospective observational study: VATS and thoracotomy in empyema of children

Introduction: The use of minimally invasive surgical techniques, such as VATS, has impacted the management of intrathoracic diseases, including empyema thoracis (ET). While VATS is superior to thoracotomy in various thoracic diseases, no specific intervention has been proven superior for ET, and its superiority in the pediatric population is not well-established. A retrospective study was conducted to compare outcomes between VATS and thoracotomy in managing ET. Methods: This is a retrospective observational study of 80 patients who underwent surgery for empyema thoracis. The patients were divided into two groups: VATS and thoracotomy. The outcomes measured were length of stay, admission days after surgery, need for segmentectomy, wound infection, pneumothorax, retained hemothorax, emphysema, redo surgery, and mortality rate. Results: There were 42 patients in the thoracotomy group and 38 patients in the VATS group. The two groups did not differ significantly in terms of age, gender, involved side, etiology, and stage of the disease. The length of stay and admission days after surgery were slightly longer in the thoracotomy group than the VATS group, but the difference was not statistically significant. The incidence of wound infection, pneumothorax, retained hemothorax, and emphysema was significantly higher in the thoracotomy group than the VATS group. However, there was no significant difference between the two groups in terms of redo surgery and mortality rate. Conclusion: VATS is associated with fewer complications, including wound infection, pneumothorax, retained hemothorax, and emphysema. Therefore, VATS should be considered as a safe surgical intervention for empyema thoracis