SynthesisIndian pediatrics2026
Intrapleural Fibrinolytic Therapy Versus Video-Assisted Thoracoscopic Surgery, as the Initial Treatment Modality, in Children with Empyema Thoracis: A Systematic Review and Meta-Analysis.
Synthesis in Indian pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
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Abstract
contextIntrapleural fibrinolytic therapy (IPFT) is frequently used in empyema thoracis as the initial treatment modality. However, some pediatricians prefer video-assisted thoracoscopic surgery (VATS). The optimal strategy is unclear.
objectiveThis systematic review was undertaken to compare IPFT versus VATS as the initial treatment modality in children with empyema thoracis, to support an evidence-based guideline recommendation. EVIDENCE ACQUISITION: Literature search was conducted in seven electronic databases and four trial registries, seeking randomized controlled trials (RCT) comparing IPFT versus VATS in children with empyema thoracis. The critical outcomes were failure of therapy, need for thoracotomy, clinical outcomes within three months of discharge, and serious adverse events. Other outcomes were mortality, clinical outcomes at ≥ 12mo of discharge and pulmonary function after discharge. Methodological quality was assessed using Cochrane RoB 2 tool. GRADE was used to assess the overall certainty of evidence.
resultsAmongst 7,738 citations, five RCTs were included. Failure of therapy (4 studies, n = 235) was comparable between IPFT versus VATS; OR 1.01, 95% CI 0.46, 2.21; I
conclusionVery low certainty evidence from five RCTs did not identify a clear difference between IPFT and VATS as the initial treatment modality in children with empyema thoracis.
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