Surgical outcome of pediatric thoracoscopic surgery: retrospective evaluation and literature review

Abstract

IntroductionMinimally invasive thoracoscopic surgical techniques are increasingly being applied in paediatrics for a multiplicity of conditions. It has been shown to minimise thoracic musculoskeletal deformity and to improve pulmonary mechanics compared to open procedures. Methods:All the children who underwent advanced thoracoscopic procedures from July 2020 up to December 2021 were retrospectively evaluated and reviewed with regard to outcome and complications. Techniques of thoracoscopic diaphragmatic hernia repair and decortication for empyema were standardized in our series. Results: There were 26 children who underwent thoracoscopic procedures, out of which 14 were neonates having congenital diaphragmatic hernia and eventration. In addition, there were five children having infective pathologies, namely four empyemas and one lung abscess. All of them had successful thoracoscopic interventions. There were five children who had thoracic neoplastic lesions including three neurogenic tumours. Thoracoscopic diaphragmatic hernia repair was showing good post-operative outcome while the repair of congenital eventration was reported to have 75% recurrence following thoracoscopic repair. Conclusions: Thoracoscopic techniques could be successfully utilized to treat a number of conditions in children. Case selection by predefined criteria and standardized technique in congenital diaphragmatic hernia repair have contributed for improved postoperative outcome. The technique of thoracoscopic repair of diaphragmatic eventration has to be revisited due to its higher recurrence rate in our setting probably due to technical difficulty. Thoracoscopic tumour resections have shown promising outcomes in our series.