The results of the Center for Pediatric Tuberculosis of the State Institution «National Institute of Tuberculosis and Pulmonology named after F.G. Yanovsky NAMS of Ukraine»
DOI:
https://doi.org/10.15574/PS.2020.68.21Keywords:
Pediatric thoracic surgery, VATS, surgical treatment of children, pediatric phthisiosurgeryAbstract
Pediatric surgeons often to have different indications for the diagnosis and treatment of pathology of the thoracic cavity. Often, only invasive techniques, such as a biopsy, can help diagnose and determine further treatment. One of the reasons for performing thoracic operations on children in Ukraine is tuberculosis.
Object. Evaluate our own results of surgical treatment of children and adolescents with pathology of the thoracic cavity.
Materials and methods. On January 1, 2019, a pediatric phthisiosurgery center was established. The results of surgical treatment of 34 children for the period from 2019 to 2020 are analyzed.
Research results and their discussion. Among the operated patients, males predominated – 18 (52.9%), the average age of patients was 12.9 years (from 4 to 17 years). The majority of patients – 20 (58.8%) were operated on for pulmonary tuberculosis, pleura, intrathoracic lymph nodes. VATS were carried out – 16 (34.0%); 1 pulmonectomy with mediastinal lymph dissection in a 10-year-old girl who was diagnosed with a myofibroblastic tumor of the upper lobe of the left lung with spread to the root of the lung; 1 (2.1%) single-port VATS chest wall biopsy of a 13-year-old boy who was diagnosed with malignant fibrous histiocytoma as a result of pathological morphology. There was no postoperative mortality. Postoperative complications developed in 3 (8.8 %) patients.
Conclusions. Surgical treatment makes it possible to increase the effectiveness of treatment of children with pulmonary TB in the epidemiological situation in Ukraine. The VATS lung biopsy is an effective method of diagnosis that can significantly speed up the time of the main diagnosis. If resection surgical treatment of lung pathology in children is necessary, anatomical resections should be preferred. VATS minimally invasive lung resections have advantages over traditional surgery using thoracotomy, due to less trauma and shortening the duration of postoperative inpatient treatment. Implantation of intravenous port systems for long-term infusions is an important element in the treatment of resistant forms of TB, which can improve adherence to treatment and reduce physical and psychological discomfort of the child, and prepare him for further surgery if necessary.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution.
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