Pediatric Surgery

[Jowels]

Shortly after he was born my son was found to have a small lump in his left arm. A tissue biopsy ruled out cancer and left hemangioma as the most likely cause. Since this can disappear on its own the consultant decided to delay surgery, but it's now 12 months later and the mass has doubled in size. As a result the consultant has now recommended surgery to remove it.

The operation is scheduled for the 18th Feb. Initially I was all for it, but after performing some google searches on pediatric anesthesia in Thailand, I've become a little anxious. It appears the number of adverse effects in pediatrics is quite high, particularly the number of serious complications, such as cardiac arrest. More worryingly, it seems a significant proportions of these are caused by human error and equipment malfunction.

The hospital where the surgery will be performed does have a good reputation. In fact we were referred there by the two most expensive private hospitals in the area (Songkhla). I intend making an appointment to discuss my concerns with the anesthetist, however, I know little about this area and their answers probably won't mean much to me. Which leads to my question, have any ThaiVisa parents been in a similar situation, and what was their impression of the medical services their child received?

Any advice/suggestions would be gratefully received.

[Sheryl]

Moved to health forum

[Sheryl]

A number of TV members have had surgery done on their children here. As with anything else, it all depends on the skill and qualification of the surgeon and anesthesiologist, and of course the state of the hospital facilities. Substandard versions of all of these can be found here, but so can world class versions.

The best hospitals are on par with the West in terms of equipment, sterility etc, and there are many western-trained pediatric surgeons and anesthesiologists here who are excellent.

So in summary it boils down to where it will be done and above all, by whom.

You want to be sure to have a specialist in pediatric anesthesiology and not just a regular anesthesiologist. Preferrably one with training in a western country. A professorship or associate professorship at a medical school is also a very good indicator.

Similiar qualifications in the surgeon: you want a pediatric surgeon, not general surgeon, and one board certified in same, with training in the west, and again a professorship is an excellent sign. Very good surgeons will usually take care not to work with a sub-standard anesthesthiologist as they are not about to lert their track record be tarnished by someone else's mistake. So normally with surgery I focus just in the surgeon's qualifications. But with such a young child it is wise to examine the qualifications of both surgeon and anesthesiologist.

Actually rather than selecting hospital I normally start by researching the best doctors, who will usually be on faculty at a major government hospital (e.g. Prince of Songkhla Univ Hosp) and then figure out where they have private practice.

As Prince of Songkhla is an excellent medical school and research center there is a good chance you can find what you need in that area but if not, might consider coming to Bangkok. The length of hospital stay for this type of procedure is likely to be quite short so would not entail being away from home long.

Well qualified pediatric anesthesiologists in Bangkok include the following at Samitivej:

http://www.samitivejhospitals.com/Doctor/D...ctorId=11907944

http://www.samitivejhospitals.com/Doctor/D...ctorId=11950634

And these at Bumrungrad:

Dr. Kasana Raksamani

Dr. Pichaya Waitayawinyu

Dr. Plernchitt Sirivanasandha

Dr. Sahatsa Mandee

Good luck

[Jowels]

Sheryl - Thanks for your excellent reply. My son is going to have the surgery at the medical hospital at Prince of Songkla University. I have spoken with the head anesthesiologist there this morning and his replies have put my mind at rest a little. Although, they don't have any specialized pediatric anesthesiologists, he has experience with over 2,000 toddlers himself, and he has agreed to anesthetize my son. I don't know specifics about his medical training, but he spoke with a very American accent, which could only have been obtained by spending considerable time there. The surgeon who will perform the operation studied in Australia, and according to other doctors, is the most highly qualified pediatric surgeon in the area. Although, I'm not expecting it to be a pleasurable experience, the hospital are prepared to waive their usual rule that only one parent can accompany the child while they are anesthetized, so at least the little fella will have the comfort of two familiar faces.

I will try to make some further inquiries regarding the surgeon and anesthesiologist's qualifications, and will also find out if they operate a private medical practice.

Thanks again for your assistance.

Edited February 10, 2010 by Jowels

[Sheryl]

The only reason to go private would be (1) to ensure that you get these doctors, as not always possible to choose your doctor at a govt hospital and (2) to have more English speaking among the staff, which of course helps a lot unless you are or can be accompanied by a Thai speaker.

Sounds like #1 no issue.

If #2 also not, I'd stay with the planned hospital, it is one of the country's best govt facilities on par with the top govt hosps in Bangkok.

Private will cost substantially more.

If you have the names of the surgeon and anesthesiologist a simple Google may come up with details of their qualifications. Also don't be hesitant to ask about things like board certification and training abraod.

[DanBlack]

We found a lump at the top of his back on our 8 month old son, when he was 3 months old. After going to every hospital in Phuket and most of them willing to try surgury, we went to Songkhla. We were impressed with the pediatric surgeon there, Dr Kritsada ? (my own spelling) By this time the lump was the size of a half grapefruit. He said the lump should stop growing and slowly come down by itself. We were asked to come back in 6 months to check. That will be in 2 months, and the lump "might" be a tiny bit smaller now.

I just realized your scheduled operation was yesterday. I hope all went well

Please let us know

[Jowels]

Hi Dan. I'm pleased to report everything went well. My son is in remarkably good spirits, and he should be discharged later this morning.

I was very impressed with all the surgical staff at Songklanagarind hospital. They took excellent care of my son, and ensured their most experienced pediatric anesthesiologist put my son 'under'. The operation was performed by a Dr. Surasak Sangkhathat. He doesn't have a particularly good bedside manner, but he graduated from Japan's (not Australia's) most respected medical university, and he is supposed to be one of southern Thailand's top pediatric surgeons. If your son's lump does require surgery, I wouldn't hesitate to recommend Songklanagarind.

Edited February 19, 2010 by Jowels

[Sheryl]

Thanks for the update, Jewels, and for the information. Glad everything went well.

[DanBlack]

Congratulations on the success of the operation.

I will keep that doctors name