Analyse the usefulness of thoracoscopy in Paediatric Population in the management of various thoracic pathologies.

Rangarajan, R (2006) Analyse the usefulness of thoracoscopy in Paediatric Population in the management of various thoracic pathologies. Masters thesis, Coimbatore Medical College, Coimbatore.


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INTRODUCTION : Video-assisted thoracoscopic surgical (VATS) procedures are being used in children since 1970s. With the advent of smaller endoscopic instruments and improvement in video technology, more VATS procedures are being performed. These procedures are very safe and efficacious in paediatric patients of all age groups including newborns. Initially, the usefulness of thoracoscopy was limited to only biopsies, decortication and deroofing of pulmonary cysts. Today, more than 20 types of VATS procedure have been introduced in infants and children. They mainly deal with diseases of the esophagus, lungs, mediastinum and diseases of the diaphragm, pleura and pericardium. VATS obviously has certain advantages such as superior cosmetic results, prevention of functional disorders of the thorax, lesser post-operative pain and faster recovery. Endosurgery has a considerable learning curve. Future of the thoracoscopy in children depends upon creation of better and new instruments. With this background, the present study is intended to analyse, various thoracoscopic procedures performed in our institution, and examine the merits and demerits of this procedure. AIMS : To analyse the usefulness of thoracoscopy in Paediatric population in the management of various thoracic pathologies in relation to its Feasibility, Safety, Efficacy, Reliability. To compare its advantages over thoracotomy in relation to Post operative pain, Recovery, Morbidity, Cosmesis. To compare our results with other studies. CONCLUSION : 1. Thoracoscopy is definitely superior to thoracotomy in the management of Empyema thoracis in relation to a. Pain relief, b. Morbidity, c. Early recovery, d. Requirement of blood transfusion. 2. Primary VATS has a role in the management of empyema thoracis. 3. Thoracoscopy can safely be done in all age groups and even in very sick children. 4. This study reveals that this is an excellent procedure for mediastinal biopsy with a very high yield. 5. This study reveals that thoracoscopy reduces the morbidity and gives better cosmetic results in case of pyopericardium. 6. Thoracoscopy definitely reduces the morbidity and hospital stay in cases of CDH repair. 7. Cystic lesion of the lung can be excised safely and effectively by thoracoscopy. 8. Procedures like thoracoscopic esophageal atresia repair need more operative time and expertise and specialized instruments. 9. This study also reveals that thoracoscopic procedures can be done with conventional dual lung ventilation with induced pneumothorax. One lung ventilation or double lumen tubes are not mandatory. 10. Our experience reveals that complications encountered in thoracoscopy are usually minor.

Item Type: Thesis (Masters)
Uncontrolled Keywords: thoracoscopy ; Paediatric Population ; management ; thoracic pathologies.
Subjects: MEDICAL > Paediatric Surgery
Depositing User: Kambaraman B
Date Deposited: 31 Jul 2017 04:09
Last Modified: 31 Jul 2017 04:09

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