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The Pediatric Forum
February 2010

Video-Assisted Thorascopic Surgery vs Chest Drain With Fibrinolytics for the Treatment of Pleural Empyema in Children: A Systematic Review of Randomized Controlled Trials

Author Affiliations

Author Affiliations: Division of Paediatric Medicine & Paediatric Outcomes Research Team (Drs Mahant, Cohen, and Weinstein), and Division of Infectious Disease (Dr Wadhwa), Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Arch Pediatr Adolesc Med. 2010;164(2):201-203. doi:10.1001/archpediatrics.2009.271

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.13 We conducted a systematic review of randomized controlled trials (RCTs) to compare the effectiveness of these treatments for pleural empyema in children.

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