Paediatric Thoracic Surgery is a specialized field that focuses on diagnosing and surgically treating congenital and acquired conditions affecting the chest, lungs, diaphragm, and esophagus in infants, children, and adolescents. These surgeries are often complex and require a multidisciplinary approach involving pediatric surgeons, neonatologists, anesthesiologists, and respiratory specialists.

1. Common Pediatric Thoracic Conditions & Their Surgical Treatments

A. Congenital Thoracic Disorders (Present at Birth)

1. Congenital Diaphragmatic Hernia (CDH)
   • Problem: A hole in the diaphragm allows abdominal organs to move into the chest, affecting lung development.
   • Treatment: Surgical repair to reposition organs and close the diaphragm defect.
2. Congenital Pulmonary Airway Malformation (CPAM)
   • Problem: Abnormal lung tissue growth that can cause breathing issues.
   • Treatment: Lobectomy (removal of the affected lung lobe).
3. Bronchogenic Cyst
   • Problem: Fluid-filled cysts in the lungs or mediastinum (chest cavity).
   • Treatment: Surgical excision to prevent infections and breathing difficulties.
4. Esophageal Atresia & Tracheoesophageal Fistula (EA/TEF)
   • Problem: The esophagus is improperly formed, leading to feeding and breathing difficulties.
   • Treatment: Primary surgical repair to connect the esophagus and separate it from the trachea.
5. Pectus Excavatum (“Sunken Chest”) & Pectus Carinatum (“Pigeon Chest”)
   • Problem: Chest wall deformities affecting breathing and heart function.
   • Treatment:
     • Pectus Excavatum: Nuss procedure (minimally invasive bar placement).
     • Pectus Carinatum: Bracing or surgical correction.

B. Acquired Pediatric Thoracic Disorders

1. Empyema (Pus in the Pleural Cavity Due to Infection)
   • Problem: Complication of pneumonia leading to pus accumulation in the chest.
   • Treatment:
     • Chest tube drainage.
     • Video-assisted thoracoscopic surgery (VATS) for severe cases.
2. Pneumothorax (Collapsed Lung)
   • Problem: Air leaks into the pleural space, causing lung collapse.
   • Treatment:
     • Chest tube placement for minor cases.
     • Surgery (pleurodesis) for recurrent pneumothorax.
3. Mediastinal Tumors (Tumors in the Chest Cavity)
   • Examples: Neuroblastoma, teratoma, lymphoma.
   • Treatment: Surgical excision, often combined with chemotherapy or radiation.
4. Foreign Body Aspiration (Inhaled Objects in Airways)
   • Problem: Blockage of the airway due to accidental inhalation of food or objects.
   • Treatment: Rigid bronchoscopy to remove the object.

2. Pediatric Thoracic Surgical Techniques

• Minimally Invasive Surgery (MIS): Video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgery for reduced pain and quicker recovery.
• Open Thoracotomy: Used for complex cases where minimally invasive approaches are not sufficient.
• Endoscopic & Bronchoscopic Procedures: Used for diagnosis and treatment of airway obstructions.

3. Postoperative Care & Long-Term Management

• Respiratory Support: Some children may need oxygen therapy post-surgery.
• Pain Management & Rehabilitation: To ensure proper healing and lung function recovery.
• Follow-up Monitoring: Regular check-ups to assess lung and chest wall function.