Thoracoscopy and solid tumors in children: a multicenter study.
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.
Guye
Emmanuelle
E
Division of Pediatric Surgery, University of Saint-Etienne, North Hospital, France. guyemanu@yahoo.fr
Lardy
Hubert
H
Piolat
Christian
C
Bawab
Fariz
F
Becmeur
François
F
Dyon
Jean-François
JF
Marteau
Marion
M
Lavrand
Fédéric
F
Lefebvre
Francis
F
Podevin
Guillaume
G
Reinberg
Olivier
O
Varlet
François
F
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