Surgery versus intrapleural fibrinolysis for management of complicated pleural infections: a systematic review and meta-analysis.
Respir Res
; 25(1): 323, 2024 Aug 24.
Article
en En
| MEDLINE
| ID: mdl-39182102
ABSTRACT
BACKGROUND:
Complicated pleural infection comprises of complex effusions and empyema. When tube thoracostomy is ineffective, treatment options include surgical drainage, deloculation and decortication or intrapleural fibrinolysis. We performed a systematic review and meta-analysis to examine which technique is superior in treating complicated pleural infections.METHODS:
PubMed, MEDLINE and EMBASE databases were searched for studies published between January 2000 to July 2023 comparing surgery and intrapleural fibrinolysis for treatment of complicated pleural infection. The primary outcome was treatment success. Secondary outcomes included hospital length of stay, chest drain duration and in-hospital mortality.RESULTS:
Surgical management of complicated pleural infections was more likely to be successful than intrapleural fibrinolysis (RR 1.18; 95% CI 1.02, 1.38). Surgical intervention group benefited from statistically significant shorter hospital length of stay (MD 3.85; 95% CI 1.09, 6.62) and chest drain duration (MD 3.42; 95% CI 1.36, 5.48). There was no observed difference between in-hospital mortality (RR 1.00; 95% CI 0.99, 1.02).CONCLUSION:
Surgical management of complicated pleural infections results in increased likelihood of treatment success, shorter chest drain duration and hospital length of stay in the adult population compared with intrapleural fibrinolysis. In-hospital mortality did not differ. Large cohort and randomized research need to be conducted to confirm these findings.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Terapia Trombolítica
Límite:
Humans
Idioma:
En
Revista:
Respir Res
Año:
2024
Tipo del documento:
Article
País de afiliación:
Australia