Thoracoscopic resection of intra- and extralobar pulmonary sequestration in the first 3 months of life.
BACKGROUND
Thoracoscopic techniques have gained increasing acceptance in pediatric surgery, but experience with newborns and small children is limited. To our knowledge, a series of minimally invasive resection of pulmonary sequestration in newborns has not yet been reported in the literature. We report on 5 patients with pulmonary sequestration thoracoscopically.


METHODS
From November 2000 to November 2002, 5 patients underwent thoracoscopic resection of pulmonary sequestration. Ages ranged from 4 to 91 days. Two patients had postnatal pulmonary symptoms. Preoperative diagnosis was dubious in 4 children. There were 4 extralobar and 1 intralobar pulmonary sequestrations.


RESULTS
Thoracoscopy was performed with 3-mm instruments and 3 to 5 ports. All procedures were completed successfully. The median duration of the operation was 95 minutes (range, 63-117 minutes), and visualization was excellent. Anomalous blood vessels were clipped and/or ligated. Four patients were extubated immediately after the operation, 1, the day after. The postoperative course was uneventful in all children. At follow-up after 14 months (mean; range, 10-19 months), all patients were free of symptoms and had normal chest x-rays.


CONCLUSIONS
Thoracoscopy is feasible for resection of intra- and extralobar pulmonary sequestrations during the first 3 months of life.
Jesch
Natalie K
NK
Department of Pediatric Surgery, Hannover Medical School, 30625 Hannover, Germany. jesch.natalie@mh-hannover.de
Leonhardt
Johannes
J
Sumpelmann
Robert
R
Gluer
Sylvia
S
Nustede
Rainer
R
Ure
Benno M
BM
D001998:Bronchopulmonary Sequestration / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013906:Thoracoscopy / Q000379:methods*; D016896:Treatment Outcome