Thursday, October 30, 2014

For Treating Empyema, Which Is Better—Urokinase Drainage or Video-Assisted Thoracoscopy?

By: Lewis First, MD, MS; Editor-in-Chief 

Video-assisted thoracoscopy.
Image by Cancer Research UK  via Wikimedia Commons.
Every once in a while we have a patient who develops a parapneumonic effusion of pus (otherwise known as an empyema) as a complication of an acute bacterial pneumonia. When this happens, treatment might involve a chest tube and when that fails, the use of thoracoscopy.

Recently however, the addition of urokinase to enzymatically break apart the empyema has been suggested to make the chest-tube drainage method more effective—but is it as effective as video-assisted thoracoscopy (VATS)?

Marhuenda et al. (doi:10.1542/peds.2013-3935) approached this question by performing a prospective randomized multicenter clinical trial in children younger than 15 years old with empyema that required intervention.

The results indicate that urokinase plus drainage may be just as effective as VATS, but if you want to see for yourself, scope out this study and discuss it with your local pediatric surgeons to see if they agree the two treatments are similar. Be sure to share what you learn with us by leaving a comment here on the blog, sharing an eLetter on our journal’s website or visiting us on Facebook or Twitter.

Related Reading:

No comments:

Post a Comment

Thank you for joining in the conversation. Please follow our commenting guidelines, which you can find on our "About First Read" page.