Current Application of Thoracoscopy in Children
- 1 February 2008
- journal article
- research article
- Published by Mary Ann Liebert Inc in Journal of Laparoendoscopic & Advanced Surgical Techniques
- Vol. 18 (1), 131-135
- https://doi.org/10.1089/lap.2007.0154
Abstract
Background: The safety and efficacy of thoracoscopy for thoracic lesions and conditions in children is evolving. Our experience with thoracoscopy has expanded in recent years. Therefore, we reviewed our most recent 7-year experience to examine the current applications for thoracoscopy in children. Methods: A retrospective review of all patients undergoing a thoracoscopic operation at Children's Mercy Hospital (Kansas City, MO) between January 1, 2000, and June 18, 2007, was performed. Data points reviewed included patient demographics, type of operation, final diagnosis, complications, and recovery. Results: During the study period, 230 children underwent 231 thoracoscopic procedures. The mean age was 9.6 ± 6.1 years with a mean weight of 36.6 ± 24.1 kg. Fifty percent of the patients were male. The thoracoscopic approach was used for decortication and debridement for empyema in 79 patients, wedge resection for lung lesions in 37, exposure for correction of scoliosis in 26, excision or biopsy of an extrapulmonary mass in 26, operation for spontaneous pneumothorax in 25, lung biopsy for a diffuse parenchymal process in 15, lobectomy in 9, repair of esophageal atresia with a tracheoesophageal fistula (EA-TEF) in 8, clearance of the pleural space for hemothorax or effusion in 3, diagnosis for trauma in 1, and repair of bronchopleural fistula in 1. Conversion was required in 3 patients, all of whom were undergoing a lobectomy. Two of these were right upper lobectomies and the other was a left lower lobectomy with severe infection and inflammation. The mean time of chest tube drainage (excluding scoliosis and EA-TEF patients) was 2.9 ± 2.0 days. There were no major intraoperative thoracoscopic complications. A correct diagnosis was rendered in all patients undergoing a biopsy. One patient required a second thoracoscopic biopsy to better define a mediastinal mass. Two patients developed postoperative atelectasis after scoliosis procedures. One patient had a small persistent pneumothorax after a bleb resection for a spontaneous pneumothorax. This subsequently resolved. Conclusions: In pediatric patients with thoracic pathology, thoracoscopy is highly effective for attaining the goal of the operation, with a low rate of conversion and complications.Keywords
This publication has 14 references indexed in Scilit:
- Parapneumonic Effusion and Empyema in Children: Retrospective Review of the duPont ExperienceClinical Pediatrics, 2007
- The Use of Biosynthetic Mesh to Separate the Anastomoses During the Thoracoscopic Repair of Esophageal Atresia and Tracheoesophageal FistulaJournal of Laparoendoscopic & Advanced Surgical Techniques, 2007
- A comparison of chest tubes versus bulb-suction drains in pediatric thoracic surgeryJournal of Pediatric Surgery, 2007
- Minimal access thoracic surgery in the pediatric populationSeminars in Pediatric Surgery, 2007
- The role of thoracoscopy in the treatment of pleural empyema in childrenSurgical Endoscopy, 2006
- Minimally Invasive Management of Thoracoabdominal Penetrating Trauma in a ChildJournal Of Trauma-Injury Infection and Critical Care, 2006
- The use of stab incisions for instrument access in laparoscopic operationsJournal of Pediatric Surgery, 2003
- The safety and efficacy of thoracoscopic lung biopsy for diagnosis and treatment in infants and childrenJournal of Pediatric Surgery, 1996
- Pediatric thoracoscopy: Where have we come and what have we learned?The Annals of Thoracic Surgery, 1993
- Thoracoscopy in ChildrenAnnals of Surgery, 1979