Estudio comparativo de las complicaciones postoperatorias inmediatas de la toracoscopia frente a la toracotomía en la escoliosis idiopática infantil

Complication of surgery for scoliosis in children with surgically corrected congenital cardiac malformations

“…Anaesthetic morbility and mortality of such patients, however, is less than 2%. In 2 previous studies carried out in our hospital, 3 , 9 we analysed the surgical and postoperative complications of children undergoing scoliosis surgery without the complication of congenitally malformed hearts. None of these patients required inotropic support during surgery, as opposed to one-fifth of the patients in our present study.…”

“…Spinal surgery in these children is difficult, and is associated with a significant number of complications, including severe coagulopathies, excessive intraoperative and postoperative bleeding, infection of deep wounds, atelectasis, arrhythmias, congestive cardiac failure, cardiopulmonary arrest, and death. 9 In this report, we describe the medical complications detected in our department over a period of 7 years in children undergoing spinal surgery who had previously undergone cardiothoracic surgery for treatment of their congenitally malformed hearts.…”

Cirurgia toracoscópica na abordagem da escoliose idiopática: Revisão sistemática de literatura

“…In addition, the technique involves the division of the serratus anterior and latissimus dorsi muscles, which can lead to long thoracic nerve injury and muscle atrophy. 15,16 Although modern thoracotomy techniques in the pediatric population try to spare critical muscles and not resect the costal arches, functional and operative risks remain significant aspects to consider when selecting a procedure. 17 Thus, the traditional surgical techniques for idiopathic scoliosis include release and open anterior instrumentation, posterior instrumentation, and thoracoscopic approaches.…”

“…A técnica também envolve a divisão dos músculos serrátil anterior e grande dorsal, o que posteriormente pode ocasionar lesões do nervo torácico longo e atrofias musculares. 15,16 Embora técnicas modernas de toracotomia na população pediátrica tentem preservar os principais músculos, bem como optem pela não ressecção de arcos costais os riscos funcionais e operatórios persistem como importantes aspectos a serem considerados na escolha do procedimento. 17 Assim, tem-se que as técnicas tradicionais para abordagem cirúrgica da escoliose idiopática incluem liberação e instrumentação anterior aberta, instrumentação posterior e as abordagens toracoscópicas.…”