Department of Paediatrics, Monash University, Melbourne, Australia.
Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Australia.
Pediatr Surg Int. 2021 Jul;37(7):897-902. doi: 10.1007/s00383-021-04887-1. Epub 2021 Mar 22.
To define the spectrum of management for thoracic empyema in children in Australia and New Zealand.
Online survey of members of the Australian and New Zealand Association of Paediatric Surgeons (ANZAPS), limited to consultant/attending paediatric surgeons.
A total of 54/80 (67.5%) members, from 16 paediatric surgical centres, responded. The majority (33/54, 61%) preferred chest drain with fibrinolytics, whilst 21/54 (39%) preferred video-assisted thoracoscopic surgery (VATS) with drain insertion. Urokinase was the most commonly used fibrinolytic (64%). There were no significant differences in management preferences between practising surgeons in Australia and New Zealand (p = 0.54), nor between consultants who had been practising a shorter (< 5 years) or longer (> 20 years) amount of time (p = 0.21). The practices described by the surveyed ANZAPS members were in line with the Thoracic Society of Australia and New Zealand recommendations for the management of paediatric empyema.
Across Australia and New Zealand there exists significant variation surrounding the intra- and post-intervention management of thoracic empyema in children. The surveyed paediatric surgeons demonstrated a preference for fibrinolytics over the use of VATS. All management regimens were within published local guidelines.
定义澳大利亚和新西兰儿童脓胸的管理范围。
对澳大利亚和新西兰小儿外科学会（ANZAPS）的成员进行在线调查，仅限于顾问/主治儿科外科医生。
共有来自 16 个小儿外科中心的 54/80（67.5%）名成员做出了回应。大多数（33/54，61%）人更喜欢带纤维蛋白溶解剂的胸腔引流，而 21/54（39%）人更喜欢带引流管的电视辅助胸腔镜手术（VATS）。尿激酶是最常用的纤维蛋白溶解剂（64%）。澳大利亚和新西兰的执业外科医生之间（p = 0.54），以及从业时间较短（< 5 年）或较长（> 20 年）的顾问之间（p = 0.21），在管理偏好方面没有显著差异。接受调查的 ANZAPS 成员所描述的做法符合澳大利亚和新西兰胸科协会对小儿脓胸的管理建议。
在澳大利亚和新西兰，儿童脓胸的围术期和术后管理存在很大差异。调查的小儿外科医生倾向于使用纤维蛋白溶解剂，而不是使用 VATS。所有的治疗方案都在当地公布的指南范围内。
