Simplified Thoracic Extra-Pleural (STEP) Approach for Open Decortication in Late Stages of Pediatric Empyema Thoracis: A Technical Note.
Open decortication (OD) is indicated in stage III (organized stage) of pediatric empyema thoracis (PET). Conventional open decortication (COD) has a sketchy description in the literature and variable results. We adopted extrapleural approach, previously described for radical pleurectomy in mesotheli...
| Publicado en: | Indian Journal of Surgery Vol. 83; no. 6; pp. 1524 - 1530 |
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| Autores principales: | , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Springer Nature
Dec2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=154087790&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 154087790 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09722068 SV1 jtl: Indian Journal of Surgery issn: 09722068 maglogo: N pubinfo: dt: Dec2021 vid: 83 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 154087790 153078495 154087790 154087790 10.1007/s12262-020-02715-9 154087790 ppf: 1524 ppct: 6 formats: tig: atl: Simplified Thoracic Extra-Pleural (STEP) Approach for Open Decortication in Late Stages of Pediatric Empyema Thoracis: A Technical Note. aug: au: Agrawal, Vikesh Acharya, Himanshu Sharma, Dhananjaya affil: Department of Surgery, Pediatric Surgery Unit, Netaji Subhash Chandra Bose Medical College, 482003, Jabalpur, India sug: subj: Empyema Surgery Thoracic Surgery Methods Treatment Outcomes Human Child India Retrospective Design Tertiary Health Care Data Analysis Software Treatment Duration Blood Loss, Surgical Postoperative Period Blood Transfusion Length of Stay Wound Infection Readmission Child: 6-12 years ab: Open decortication (OD) is indicated in stage III (organized stage) of pediatric empyema thoracis (PET). Conventional open decortication (COD) has a sketchy description in the literature and variable results. We adopted extrapleural approach, previously described for radical pleurectomy in mesothelioma, and describe Simplified Thoracic Extra-Pleural (STEP) approach as a step-wise technique for OD and compared with the COD. This retrospective study was conducted from January 2012 to December 2019 in a tertiary care center in Central India. All children (< 18 years) with organized stage of PET (according to Jabalpur image-based staging algorithm), conversion of video-assisted thoracoscopic surgery (VATS), and failed VATS were included. STEP decortication followed a step-wise approach of decortication and identification of safety boundaries. Outcomes were compared in terms of blood loss and transfusion, operative duration, hospital stay, complications, and readmission. Statistical analysis was performed using the Statistical Package for Social Sciences program, version 16.0. Ninety-three cases were divided into two groups based on approaches adopted by two surgeons in the unit, COD (47) and STEP (46). Male:female ratio was 55:38, with a median age of 4 years (IQR, 2–5). The two groups were demographically similar. The operative duration, blood loss, need for postoperative blood transfusion, prolonged air leak > 7 days, ICTD days, and hospital stay were significantly (p < 0.05) lower in the STEP group. The wound infection, recurrent collections, and readmission were similar in both groups. There was no mortality in either group. The STEP approach is a simple, useful, safe, and effective procedure as compared to OD. The step-wise description of the STEP approach can act as a surgical guide for surgical novice and trainees. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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