[Early postoperative complications of thoracoscopy versus thoracotomy in pediatric idiopathic scoliosis]. / Estudio comparativo de las complicaciones postoperatorias inmediatas de la toracoscopia frente a la toracotomía en la escoliosis idiopática infantil.

INTRODUCTION: Thoracoscopic surgery has been used for anterior release, discectomy, and fusion in severe scoliosis or kyphosis. The indications of thoracoscopy for the treatment of pediatric spinal deformity are similar to those of thoracotomy-based spinal surgery. OBJECTIVE: We designed a comparative study to observe the immediate complications in the postoperative period after thoracoscopy or thoracotomy for scoliosis in the pediatric population. MATERIAL AND METHODS: The postsurgical complications of 63 interventions for idiopathic scoliosis over a 10-year period were analyzed. Conventional thoracotomy was used in 37 interventions (59 %) and thoracoscopy was used in 26 (41 %). RESULTS: In patients treated with the thoracolumbar endoscopic procedure, oral nutrition was resumed earlier, the mean length of hospital stay was lower, and debit drainage or requirement of surgical drainage were lower. CONCLUSIONS: Fewer immediate postsurgical complications were observed in scoliosis surgery when thoracoscopy was used.

Estudio comparativo de las complicaciones postoperatorias inmediatas de la toracoscopia frente a la toracotomía en la escoliosis idiopática infantil / Early postoperative complications of thoracoscopy versus thoracotomy in pediatric idiopathic scoliosis

Introducción La toracoscopia es una técnica quirúrgica que se utiliza en cirugía anterior, discectomía y fusión vertebral en pacientes con escoliosis o cifosis graves. Las indicaciones de la toracoscopia para el tratamiento de la deformidad espinal son similares a las de la toracotomía. Objetivo Nos planteamos el estudio comparativo de las complicaciones postoperatorias inmediatas de la toracoscopia frente a la toracotomía en escoliosis infantil. Material y métodos Se analizó, en un período de 10 años, el postoperatorio de 63 intervenciones quirúrgicas de escoliosis idiopática, de las cuales 37 (59 %) se realizaron mediante toracotomía convencional y 26 (41 %) mediante abordaje endoscópico toracolumbar. Resultados En el grupo de pacientes a los que se les practicó un abordaje endoscópico toracolumbar la tolerancia oral fue más precoz y el tiempo de estancia media, así como el débito y requerimiento de los drenajes quirúrgicos fue menor. Conclusiones Las complicaciones de la cirugía de escoliosis en el postoperatorio inmediato son menores cuando la técnica quirúrgica empleada es la toracoscopia

Introduction Thoracoscopic surgery has been used for anterior release, discectomy, and fusion in severe scoliosis or kyphosis. The indications of thoracoscopy for the treatment of pediatric spinal deformity are similar to those of thoracotomy-based spinal surgery. Objective We designed a comparative study to observe the immediate complications in the postoperative period after thoracoscopy or thoracotomy for scoliosis in the pediatric population. Material and methods The postsurgical complications of 63 interventions for idiopathic scoliosis over a 10-year period were analyzed. Conventional thoracotomy was used in 37 interventions (59 %) and thoracoscopy was used in 26 (41 %). Results In patients treated with the thoracolumbar endoscopic procedure, oral nutrition was resumed earlier, the mean length of hospital stay was lower, and debit drainage or requirement of surgical drainage were lower. Conclusions Fewer immediate postsurgical complications were observed in scoliosis surgery when thoracoscopy was used

[Early postoperative complications after scoliosis surgery]. / Complicaciones médicas precoces en el postoperatorio de cirugía de escoliosis.

Several medical complications can occur after scoliosis surgery in children and adolescents. New surgical techniques have allowed greater degrees of scoliosis correction but have also increased the possibility of postsurgical deficit due to their greater aggressivity. We analyzed the early postsurgical complications of scoliosis surgery in a pediatric intensive care unit over a 10-year period. Seventy-six surgical procedures were performed. Of these, no complications occurred in 55 (73%). Chest X-ray revealed pulmonary atelectasia in 8 patients (10%) and pleural effusion in 7 patients (9%). Symptoms and signs of infection related to surgery were observed in only 6 children (8%). The absence of severe medical complications may be related to new surgical techniques and an experienced team.

Complicaciones médicas precoces en el postoperatorio de cirugía de escoliosis / Early postoperative complications after scoliosis surgery

Diversas complicaciones médicas pueden ocurrir tras la cirugía de columna. Las técnicas quirúrgicas actuales han permitido mayor grado de corrección de la escoliosis, pero al mismo tiempo ha aumentado la posibilidad de déficit postoperatorio debido a su mayor agresividad. Se analizaron las complicaciones precoces en el postoperatorio de cirugía de escoliosis en una unidad de cuidados intensivos a lo largo de 10 años. Se realizaron 76 intervenciones quirúrgicas, de las cuales en 55 (73 %) no hubo ningún tipo de complicaciones. En 8 pacientes (10 %) se observó en la radiografía de tórax una atelectasia pulmonar, siete (9 %) desarrollaron derrames pleurales y únicamente en 6 niños (8 %) se pudo constatar síntomas y signos infecciosos relacionados con la intervención quirúrgica. La ausencia de complicaciones médicas graves se debió, posiblemente, a la asociación de nuevas técnicas con un equipo experimentado

Several medical complications can occur after scoliosis surgery in children and adolescents. New surgical techniques have allowed greater degrees of scoliosis correction but have also increased the possibility of postsurgical deficit due to their greater aggressivity. We analyzed the early postsurgical complications of scoliosis surgery in a pediatric intensive care unit over a 10-year period. Seventy-six surgical procedures were performed. Of these, no complications occurred in 55 (73 %). Chest X-ray revealed pulmonary atelectasia in 8 patients (10 %) and pleural effusion in 7 patients (9 %). Symptoms and signs of infection related to surgery were observed in only 6 children (8 %). The absence of severe medical complications may be related to new surgical techniques and an experienced team