Muscle-Sparing Skin Crease Incision Posterolateral Thoracotomies in Pediatric Patients: Our Experience

Area of Science:

• Pediatric surgery
• Thoracic surgery
• Surgical techniques

Background:

• Standard posterolateral thoracotomies in children can lead to poor motor and aesthetic outcomes, along with increased postoperative pain.
• Muscle-sparing techniques aim to mitigate these morbidities.

Purpose of the Study:

• To evaluate the outcomes of muscle-sparing skin crease incision posterolateral thoracotomies in pediatric patients.
• To compare motor, aesthetic, and analgesia outcomes with standard techniques.

Main Methods:

• Prospective observational study from January 2016 to July 2020.
• Included pediatric patients with stage 3 empyema or pulmonary hydatidosis.
• Thirty-nine patients underwent muscle-sparing posterolateral thoracotomy.

Main Results:

• Adequate surgical exposure was achieved in all cases.
• All patients with empyema underwent decortication; 5 also had bronchopleural fistula repair.
• Ultrasound confirmed muscle integrity at 4 weeks, with satisfactory motor and aesthetic outcomes reported by most patients.

Conclusions:

• Muscle-sparing skin crease incision posterolateral thoracotomy is a safe and effective alternative to standard muscle-cutting thoracotomy.
• The technique provides satisfactory exposure and good functional and aesthetic results.
• It is particularly suitable for resource-challenged environments.