Abstract

Background: Various treatment options exist for fibropurulent empyema including intravenous antibiotics with repeated thoracocentesis, chest tube drainage, fibrinolytic therapy, video-assisted thoracic surgery (VATS) and thoracotomy with decortication.4,5 Present study was aimed to compare chest tube drainage with intrapleural urokinase versus thoracoscopic drainage for fibropurulent empyema in pediatric age group at a tertiary hospital. Material and Methods: Present study was single-center, prospective, comparative study, conducted in patients under the age of 12 years, with clinical and radiographic evidence of empyema (i.e., pleural fluid on chest X-ray) with sonographic findings of hyperechoic fluid with or without thin septation. Block randomisation scheme was used with equal allocation of subjects to urokinase group and VATS group & each group had fifteen patients. Results: In present study, pleural effusion collapse consolidation was common finding on chest X ray in Urokinase as well as VATS group. Mean period of hospitalisation in thoracostomy group was 9.3 days vs 8.4 days in VATS group but not proved to be statistically significant. We observed that frequency of hospitalization days was 6-7 days (6patient) in VATS gr and 9 days (4 patients) in thoracostomy group. Mean duration of ICD (in days) of study participants belonging to Urokinase group and VATS group was 8.2±3.10 and 6.8±3.2 respectively & there was no statistically significant difference in the mean duration of ICD.

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