Pattern and Presentation of Paediatric Patients Admitted in the Department of Thoracic Surgery of Dhaka Medical College and Hospital; A Single Centre Experience

Abstract

Background: Thoracic surgery is one of the surgical procedures that, particularly in the paediatric age group, needs a skilled and committed surgical, anaesthetic, and critical care team. The purpose of this study was to describe the disease burden, clinical features and surgical results of paediatric population who had thoracic surgery at Dhaka Medical College and Hospital, Dhaka, Bangladesh. Materials and Method: This prospective observational study was conducted in the Department of Thoracic surgery of Dhaka Medical College and Hospital (DMCH) from January 2022 to December 2025 over a period of 4 years.  Data were collected in a preformed questionnaire. Statistical analysis was performed using IBM SPSS version 26.0. Statistical significance was defined as a p-value of < 0.05. Results: A total number of 420 patients were included in the current study after fulfilling the inclusion and exclusion criteria. Most of the patients belonged to 6-11 years group (52.38%) with a mean age of 7.8±3.4 years. Shortness of breath was the most common presentation (95.23%) of the study population followed by cough (92.85%) and recurrent chest infection (30.95%).91 patients (21.66%) had varies types of congenital anomalies for which they underwent thoracic surgeries. Among them congenital diaphragmatic hernia (CDH) was the commonest one. Empyema thoracis (n=134) was the most common cause (31.90%) of admission in thoracic surgery followed by traumatic thoracic injuries (n=118). 401 patients (95.47%) underwent open procedures while only 19 (4.5%) patients had Video Assisted Thoracoscopic Surgery (VATS). Decortication (59.28%) was the major surgery done in the patients followed by repair of diaphragmatic hernia (10.95%). 61 patients suffered from various forms of post-operative complications (14.52%). Among them surgical site infection (SSI) was the commonest one (12.14%). Overall mortality rate was 1.6%. Conclusion: The current study demonstrated pediatric age group was vulnerable to various thoracic pathologies which mostly required emergency surgeries. Besides, critical congenital anomalies like tracheoesophageal fistula was the major cause of mortality in this center. Further large scale multicenter study should be conducted in order to provide a better outcome to the patients.