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TÜRKÇE
Oral Presentation - 16
Thoracoscopic Surgery in Pediatric Patients: Expanding Indications and Outcomes in a 15-Year Experience
S Fkaier*, S Ben Youssef*, S Meddeb*, BF Meriem*, M Abdelali**, S Chakroun***
*Department of Pediatric Surgery, Monastir University Hospital, Tunisia
**Department of Radiology, Fattouma Bourguiba Hospital, Monastir
***Pediatric Anesthesia and intensive care, Monastir University Hospital, Tunisia
Introduction:
Thoracoscopic surgery and other minimally invasive approaches in children has known an expansion to include several disciplines in the last decade because it is not only safe and efficient but also it reduces hospital stay in a significant way. The aim of this study is to report our experience with thoracoscopy with particular emphasis on indications and outcomes.
Materials and methods:
This is a retrospective study of charts of all patients undergoing thoracoscopic operation at the department of pediatric surgery of Fattouma Bourguiba Hospital in Monastir from 2005 to 2020.
Results:
Sixty-six thoracoscopic procedures were performed on patients aged 3 months to 16 years (mean age: 5.9 years). Among them, 40 cases of hydatic cyst were treated without conversion, though two required reintervention for emphysema, with no complications during follow-up. Thoracoscopy was also used for decortication in 8 empyema cases and for diagnostic purposes in 3 cases of recurrent pleurisy. Thoracoscopic lobectomy was performed in 5 cases, with one conversion. Five neonates underwent surgery for aortic abnormalities, and three for diaphragmatic hernia or eventration, all with uneventful recovery. A thoracoscopic metastasectomy was performed in an 18-month-old with nephroblastoma, and a 3-year-old with unresolved post-traumatic pneumothorax underwent thoracoscopy.
The average operative time was 92.5 minutes, chest tube drainage lasted 3.2 days, and hospital stays ranged from 3 to 15 days. No major intraoperative complications were reported, and early to mid-term outcomes were satisfactory.
Conclusion:
Thoracoscopy is preferred because it is associated with reduced tissue trauma, decreased pain, reduced hospital stay, and equal or even better clinical outcomes when compared to the standard surgical approaches.