First decade's experience with thoracoscopic lobectomy in infants and children

J Pediatr Surg. 2008 Jan;43(1):40-4; discussion 45. doi: 10.1016/j.jpedsurg.2007.09.015.

Abstract

Purpose: This study evaluates the safety and efficacy of thoracoscopic lobectomy in infants and children.

Methods: From January 1995 to March 2007, 97 patients underwent video-assisted thoracoscopic lobe resection. Ages ranged from 2 days to 18 years and weights from 2.8 to 78 kg. Preoperative diagnosis included sequestration/congenital adenomatoid malformation (65), severe bronchiectasis (21), congenital lobar emphysema (9), and malignancy (2).

Results: Of 97 procedures, 93 were completed thoracoscopically. Operative times ranged from 35 minutes to 210 minutes (average, 115 minutes). There were 19 upper, 11 middle, and 67 lower lobe resections. There were 3 intraoperative complications (3.1%) requiring conversion to an open thoracotomy. Chest tubes were left in 88 of 97 procedures for 1 to 3 days (average, 2.1 days). Hospital stay ranged from 1 to 12 days (average, 2.4 days).

Conclusions: Thoracoscopic lung resection is a safe and efficacious technique. It avoids the inherent morbidity of a major thoracotomy incision and is associated with the same decrease in postoperative pain, recovery, and hospital stay as seen in minimally invasive procedures.

MeSH terms

  • Adolescent
  • Bronchopulmonary Sequestration / mortality
  • Bronchopulmonary Sequestration / surgery*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Cystic Adenomatoid Malformation of Lung, Congenital / mortality
  • Cystic Adenomatoid Malformation of Lung, Congenital / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Length of Stay
  • Male
  • Minimally Invasive Surgical Procedures / adverse effects
  • Minimally Invasive Surgical Procedures / methods
  • Pain, Postoperative / physiopathology
  • Pneumonectomy / adverse effects
  • Pneumonectomy / methods*
  • Postoperative Complications / epidemiology
  • Pulmonary Emphysema / congenital
  • Pulmonary Emphysema / mortality
  • Pulmonary Emphysema / surgery*
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Thoracic Surgery, Video-Assisted / adverse effects
  • Thoracic Surgery, Video-Assisted / methods*
  • Time Factors
  • United States