Hemead Hanan, Mamdouh Nora, Allam Akram, Abdelaziz Ahmed
Department of Cardiothoracic Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Oct 30;32(4):412-418. doi: 10.5606/tgkdc.dergisi.2024.26639. eCollection 2024 Oct.
The study aimed to highlight and evaluate thoracic surgical procedures performed in children and adolescents and demonstrate the extent to which thoracic surgeons can benefit this population.
This retrospective study included 200 pediatric patients (100 males, 100 females; mean age: 14.7±6.7 years; range, 1 month to 21 years) who underwent thoracic surgery between January 2018 and January 2023. Patients' indications for surgery, surgical approach, complications, length of hospital stay, need for intensive care admission, and mortality were evaluated.
The most commonly performed surgery was sympathectomy (30.5%), followed by decortication (16%) and traumatic exploration (14%). Approximately 50% of surgeries were minimally invasive. The average length of hospital stay was 2.8 days, and the rate of intensive care admission was 20%. The intraoperative and postoperative complication rate was 10%.
The concept of treating pediatric patients as small-size adults is irrational. Pediatric patients need special care and tailored guidelines due to their peculiar physical, psychological, and anatomical characteristics. We believe that having a dedicated team of thoracic surgeons trained and subspecialized for pediatric thoracic pathologies will improve outcomes. Furthermore, more research must be directed to this age group to establish evidence-based consensus and guidelines.
本研究旨在突出和评估在儿童和青少年中实施的胸外科手术，并展示胸外科医生能在多大程度上使这一人群受益。
这项回顾性研究纳入了200例于2018年1月至2023年1月期间接受胸外科手术的儿科患者（100例男性，100例女性；平均年龄：14.7±6.7岁；范围，1个月至21岁）。评估了患者的手术指征、手术方式、并发症、住院时间、重症监护入院需求及死亡率。
最常实施的手术是交感神经切除术（30.5%），其次是纤维板剥脱术（16%）和创伤探查术（14%）。约50%的手术为微创手术。平均住院时间为2.8天，重症监护入院率为20%。术中和术后并发症发生率为10%。
将儿科患者当作小体型成年人来治疗的观念是不合理的。儿科患者因其特殊的生理、心理和解剖特征需要特殊护理和量身定制的指南。我们认为，拥有一支专门为小儿胸科疾病接受过培训且具备亚专业能力的胸外科医生团队将改善治疗效果。此外，必须针对这一年龄组开展更多研究，以建立基于证据的共识和指南。
