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Thoracic surgery in children.

Peter Kanngiesser1, Florian Liewald, Gisela Halter

  • 1Department of Thoracic and Vascular Surgery, Universitätsklinikum Ulm., Steinhövelstr. 9, 89070 Ulm, Germany. peterkanngiesser@bdc.de

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|June 1, 2005
PubMed
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Pediatric thoracic surgery is rare but successful for benign conditions, offering good quality of life. Oncologic cases show promise, but caution is advised for immunodeficient patients due to high mortality risks.

Area of Science:

  • Pediatric Thoracic Surgery
  • Pediatric Oncology
  • Pediatric Immunology

Background:

  • Thoracic surgical procedures in children are infrequent and categorized into oncologic, immune defects, malformations, infections, and trauma.
  • Anatomical differences in children necessitate modified diagnostic and surgical techniques compared to adults.

Purpose of the Study:

  • To analyze the outcomes of thoracic surgical procedures performed in children.
  • To evaluate the safety, efficacy, and quality of life associated with pediatric thoracic surgery.

Main Methods:

  • Retrospective analysis of 49 thoracic surgical procedures performed on 37 children (3 months-15 years) between 1992 and 2001.
  • Indications included oncologic disease (n=20), immunodeficiency (n=5), malformations (n=6), and trauma (n=3).

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  • Postoperative clinical course, pulmonary function tests (n=16), and quality of life (Karnofsky index, n=24) were assessed.

    • Main Results:

    • Procedures included atypical resections (n=27), lobectomies (n=7), pneumonectomy (n=1), decortications (n=3), and mediastinotomies (n=4).
    • Two of six patients with immune defects died perioperatively; 55% of oncologic patients remained disease-free.
    • Quality of life scores were high (≥80% Karnofsky index) in 24 children.

    Conclusions:

    • Pediatric thoracic surgery for benign conditions yields favorable prognoses and high quality of life.
    • Surgical treatment of pulmonary metastases is a viable oncologic therapy option for selected children.
    • Diagnostic thoracotomies in immunocompromised children require critical risk-benefit assessment due to high perioperative mortality.