Fast track pediatric thoracic surgery: Toward day-case surgery?
J Pediatr Surg
; 52(11): 1800-1805, 2017 Nov.
Article
em En
| MEDLINE
| ID: mdl-28259381
ABSTRACT
PURPOSE:
Thoracoscopic lung resection for congenital pulmonary airway malformation (CPAM) is a safe technique for children. Our purpose was to evaluate the feasibility of a fast-track protocol in such cases.METHODS:
From September 2007 to May 2016, 101 patients underwent a thoracoscopic pulmonary resection of which 83 for CPAM (lobectomy, wedge resection or sequestrectomy). We retrospectively reviewed the characteristics of surgical procedure, postoperative management and complications through three time periods (September 2007-December 2009 n=14, January 2010-March 2013 n=30, April 2013-May 2016 n=39) corresponding to management protocols modifications introducing fast-track pathways.RESULTS:
Through the 3 time periods, median postoperative hospital stay decreases (4, 3, 2days successively, P=0.02). In the third time period, 4 patients underwent surgery in day-case surgery. The overall and surgical complication rates, mainly related to air leakage, remain stable through the 3 time periods (14%, P=0.41 and 10%, P=0.52 respectively). Among the 13 patients without postoperative pleural drainage, one required secondary drainage after a partial resection of an emphysema.CONCLUSION:
Fast-track protocol for children undergoing uncomplicated thoracic surgery for CPAM seems feasible without extra morbidity. Selected patient undergoing thoracoscopic resection of the lung may benefit from the absence of pleural drainage and can be operated on in day-case surgery. LEVEL OF EVIDENCE Level III.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Pneumonectomia
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Anormalidades do Sistema Respiratório
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Procedimentos Cirúrgicos Ambulatórios
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Tempo de Internação
Tipo de estudo:
Observational_studies
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article