gms | German Medical Science

Introduction: Thoracic surgery in children, adolescents and young adults is unfrequent. Indications and operative management differ from the older patients. In a retrospectively review we examine diagnosis and operative approach in this special patient group.

Methods: Since September 2000 we retrospectively studied diagnosis and operative procedure in children, adolescents and young adults up to about 25 years. All major thoracic procedures were included. Minor thoracic interventions like pleurocentesis or chest tube insertion, diagnostic procedures for histologic specimen, thoracic pacemaker surgery or reinterventions after cardiac surgery were excluded. Surgery for congenital aortic defects (PDA, coarctation) were excluded too.

Results: In this 65 months period in 72 patients a major thoracic surgical procedure was performed. Mean age was 13.9 years, range 3 months to 26 years; 21 patients were younger than 10 years (29%). In 19 patients (26.4%) a metastasectomy was performed, in a third of these patients even two or three times. In 9 patients (12.5%) a pleurectomy with wedge resection because of pneumothorax was done. In each group with diagnosis of primary thoracic tumor, septic condition or congenital defects 8 patients (11.1%) were operated. Chest wall procedures were done in 7 patients (9.7%). Miscellaneous operative procedures (trauma, hyperhidrosis, etc.) were performed in 13 patients (18%).

Conclusion: Surgery in children, adolescents and young adults has different indications. Often even in this group metastatic lung surgery is required. Surgery due to pneumothorax is also often performed. Other interventions are rare.