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Thoracotomy in Children: Review from a Low-Income Country
Hana Abebe Gebreselassie1, Mekdelawit Mesfin Tadesse2, Hanna Getachew Woldeselassie3
1Department of Surgery, Pediatrics Surgery Unit, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Pediatric Health, Medicine and Therapeutics
|March 20, 2023
Summary
Pediatric thoracotomy for non-cardiac conditions in a low-income country showed pulmonary hydatid cyst as the main indication. The study highlighted suboptimal post-operative pain management and significant morbidity and mortality rates.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Global Health
Background:
- Thoracotomy is a critical surgical procedure for various pediatric congenital and acquired conditions.
- Implementing thoracotomy requires specialized teams, which are challenging to assemble in low-income countries.
- Data on the patterns and outcomes of pediatric thoracotomy in low-resource settings are scarce.
Purpose of the Study:
- To investigate the indications, approaches, and outcomes of pediatric thoracotomy in a low-income country.
- To analyze the post-operative pain management strategies employed.
- To determine the morbidity and mortality rates associated with pediatric thoracotomy in this setting.
Main Methods:
- A descriptive cross-sectional review of pediatric patients undergoing non-cardiac thoracotomy.
- Collection of demographic and clinical data through chart review.
- Analysis of categorical variables using frequencies and percentages, and continuous variables using descriptive statistics.
Main Results:
- A total of 68 pediatric patients underwent thoracotomy, with males constituting 64.7%.
- Pulmonary hydatid cyst (25%) and congenital lobar emphysema (16.2%) were the most frequent indications.
- Muscle sparing posterolateral thoracotomy was the predominant surgical approach (97.1%), with suboptimal post-operative analgesia and notable morbidity (11.8%) and mortality (8.8%) rates.
Conclusions:
- Pulmonary hydatid cyst is the leading indication for pediatric thoracotomy in this low-income setting.
- Post-thoracotomy analgesia was suboptimal, lacking regional blocks and multimodal approaches.
- Pediatric thoracotomy in this resource-limited environment is associated with considerable morbidity and mortality.
