title: Thoracoscopy and solid tumors in children: a multicenter study.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy and safety of thoracoscopy in the treatment of solid thoracic tumors in children.
  
  
  METHODS
  A retrospective, multicenter review of 139 thoracoscopies was performed. The procedures were either resection of pulmonary lesions or biopsy. Complications, histologic biopsy results, and outcomes were reviewed.
  
  
  RESULTS
  One hundred thirty-nine procedures were performed in 134 children. There were 72 males and 62 females, with a mean age of 9.2 years (3 months to 17 years). The mean follow-up was 4.5 years. Thirty-eight primitive tumors were managed, 20 of which had a complete thorascopic resection, and nine biopsies were performed. In 9 additional cases, an open conversion was necessary. Among the 20 complete resections, 17 of the lesions were neurogenic tumors (i.e., neuroblastoma or ganglioneuroma). Three complications occurred: 2 chylothoraces and 1 with Horner syndrome. All three complications regressed. The mean follow-up was 3 years, and no recurrence has been noted. Fifty-three metastatic lesions were managed: 29 had a complete resection, 11 had a biopsy, and an open conversion was necessary in 13 cases. Among the complete resections, more than half were metastases from bone tumors. The mean follow-up was approximately 4 years and 5 pulmonary recurrences developed. Four deaths occurred, with 2 having had lung metastases. Forty-eight malignant hemopathies were managed; 9 biopsies for primitive tumors were performed. There were 36 secondary lesions, of which 5 were completely resected; 30 were biopsied and 1 required an open conversion.
  
  
  CONCLUSIONS
  Thoracoscopy is a safe, effective approach for the evaluation and resection of solid lung tumors and for biopsy. Thoracoscopic resection of metastatic lesions is reasonable for nephroblastoma, but a thoracotomy is suggested for other metastases.
authors.affiliation: Division of Pediatric Surgery, University of Saint-Etienne, North Hospital, France. guyemanu@yahoo.fr
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Guye
authors.forename: Hubert
authors.initials: H
authors.lastname: Lardy
authors.forename: Christian
authors.initials: C
authors.lastname: Piolat
authors.forename: Fariz
authors.initials: F
authors.lastname: Bawab
authors.forename: François
authors.initials: F
authors.lastname: Becmeur
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Dyon
authors.forename: Marion
authors.initials: M
authors.lastname: Marteau
authors.forename: Fédéric
authors.initials: F
authors.lastname: Lavrand
authors.forename: Francis
authors.initials: F
authors.lastname: Lefebvre
authors.forename: Guillaume
authors.initials: G
authors.lastname: Podevin
authors.forename: Olivier
authors.initials: O
authors.lastname: Reinberg
authors.forename: François
authors.initials: F
authors.lastname: Varlet
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009362:Neoplasm Metastasis; D011183:Postoperative Complications; D012189:Retrospective Studies; D013899:Thoracic Neoplasms / Q000473:pathology / Q000601:surgery*; D013906:Thoracoscopy; D016896:Treatment Outcome