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[Thoracic surgery in children]
1Odense Universitetshospital, thorax-karkirurgisk afdeling T.
Insights
Pediatric thoracic surgery is effective for various conditions, though severe primary diseases increase mortality risk in children. This review analyzes surgical outcomes for non-cardiac thoracic conditions in patients under 16.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Neonatal Care
Context:
- Review of pediatric non-cardiac thoracic surgeries from 1987-1996 at Odense University Hospital.
- Analysis included 33 neonates with pneumothorax, 55 with primary intrathoracic diseases, and 38 with secondary thoracic involvement.
Purpose:
- To evaluate the outcomes and tolerance of non-cardiac thoracic surgery in children.
- To identify factors influencing mortality in pediatric thoracic surgical patients.
Summary:
- Neonatal pneumothorax cases had a 36% mortality rate within five days.
- Primary thoracic diseases showed age-related patterns (congenital in younger, traumatic in older children).
- No immediate postoperative deaths occurred, but 7/55 (13%) and 11/38 (29%) died at follow-up for primary and secondary conditions, respectively.
Impact:
- Thoracic surgery is generally well-tolerated in pediatric patients.
- Severe primary thoracic diseases are associated with increased mortality.
- Findings highlight the need for careful management of complex pediatric thoracic conditions.
Abstract:
In order to study non-cardiac thoracic surgery in children we reviewed the files of all children under 16 years, who had surgery at the Department of Thoracic and Cardiovascular Surgery, Odense University Hospital from 1987 to 1996. Thirty-three children had chest tube insertion because of neonatal pneumothorax. Twelve of these died within five days after birth. Fifty-five children had surgery for primary intrathoracic diseases. Congenital pulmonary malformations were most common in the youngest children. Traumatic diseases were most common in the oldest. No immediate postoperative deaths occurred, but seven children were dead at the follow-up. Thirty-eight had surgery for involvement of the thoracic organs secondary to other often malignant diseases. Eleven of these were dead at the follow-up. It is concluded, that thoracic surgery is required for a number of diseases in children and is well tolerated. However, severe primary diseases lead to an increased mortality.