Management of thoracic empyema in children: a survey of the Australia and New Zealand Association of Paediatric Surgeons (ANZAPS).

Publisher: Springer International Country of Publication: Germany NLM ID: 8609169 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1437-9813 (Electronic) Linking ISSN: 01790358 NLM ISO Abbreviation: Pediatr Surg Int Subsets: MEDLINE

Original Publication: Berlin : Springer International, c1986-

Disease Management*; Empyema, Pleural/*surgery ; Thoracic Surgery, Video-Assisted/*methods; Adolescent ; Australia/epidemiology ; Chest Tubes ; Child ; Child, Preschool ; Empyema, Pleural/epidemiology ; Female ; Humans ; Incidence ; Male ; New Zealand/epidemiology ; Surveys and Questionnaires ; Young Adult

Purpose: To define the spectrum of management for thoracic empyema in children in Australia and New Zealand.
Methods: Online survey of members of the Australian and New Zealand Association of Paediatric Surgeons (ANZAPS), limited to consultant/attending paediatric surgeons.
Results: A total of 54/80 (67.5%) members, from 16 paediatric surgical centres, responded. The majority (33/54, 61%) preferred chest drain with fibrinolytics, whilst 21/54 (39%) preferred video-assisted thoracoscopic surgery (VATS) with drain insertion. Urokinase was the most commonly used fibrinolytic (64%). There were no significant differences in management preferences between practising surgeons in Australia and New Zealand (p = 0.54), nor between consultants who had been practising a shorter (< 5 years) or longer (> 20 years) amount of time (p = 0.21). The practices described by the surveyed ANZAPS members were in line with the Thoracic Society of Australia and New Zealand recommendations for the management of paediatric empyema.
Conclusion: Across Australia and New Zealand there exists significant variation surrounding the intra- and post-intervention management of thoracic empyema in children. The surveyed paediatric surgeons demonstrated a preference for fibrinolytics over the use of VATS. All management regimens were within published local guidelines.

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Keywords: Chest drain; Empyema; Fibrinolytics; Paediatric surgery; Thoracic; Video-assisted thoracoscopic surgery

Date Created: 20210322 Date Completed: 20210712 Latest Revision: 20210712

20231215

10.1007/s00383-021-04887-1

33751198