There is marked variability in treatment of pleural empyema in children1,2 and a debate over whether video-assisted thoracoscopic surgery (VATS) is more effective than chest drain with fibrinolytics. A meta-analysis of observational studies and subsequent large observational studies concluded that surgical management, in particular VATS, is most effective.1- 3 We conducted a systematic review of randomized controlled trials (RCTs) to compare the effectiveness of these treatments for pleural empyema in children.
Sanjay Mahant, Eyal Cohen, Michael Weinstein, Anupma Wadhwa. Video-Assisted Thorascopic Surgery vs Chest Drain With Fibrinolytics for the Treatment of Pleural Empyema in Children: A Systematic Review of Randomized Controlled Trials. Arch Pediatr Adolesc Med. 2010;164(2):201–203. doi:10.1001/archpediatrics.2009.271