Is There a Pediatric Role for the General Thoracic Surgeon in a General Hospital? A 22-Year Single-Center Experience

Background: Although general thoracic surgery is usually focused on adult patients, there are some settings of pediatric diseases which can benefit from thoracic surgical procedures. In this study, we retrospectively reviewed the contribution of general thoracic surgeons to pediatric patients in a high-volume hospital. Methods: From September 2002 to August 2024, 8897 consecutive patients were operated on; among them, 202 patients (2.2%) were younger than 18. Age, sex, operatory setting, side, indications, procedures, procedure duration, and perioperative mortality were collected for each patient. Results: Among the 202 patients younger than 18, 27 (13.3%) were 0-6 yo; 13 (6.4%) were 6-12 yo; 162 (80.1%) were 12-18 yo. In the first group, metapneumonic pleural effusion was the most frequent indication (44.4%) and chest drain the most frequent procedure (51.8%). No perioperative mortality was reported. In the second group, metapneumonic pleural effusion was the most frequent indication (30.7%) and chest drain the most frequent procedure (46.1%). No perioperative mortality was reported. In the third group, pneumothorax was the most frequent indication (41.3%) and bullectomy the most frequent procedure; (41.3%); one intraoperative death (0.4%) was reported in a case of major trauma. Conclusions: A general thoracic surgeon can effectively contribute to the surgical care of pediatric patients; in younger patients (<12 yo) urgent procedures related to infections are the most commonly performed; on the other hand, in patients aged between 12 and 18, elective procedures are more commonly performed, these being sympathectomy for hyperhidrosis and bullectomy for pneumothorax the most frequent.