First decade's experience with thoracoscopic lobectomy in infants and children.
OBJECTIVE
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.
Rothenberg
Steven S
SS
The Rocky Mountain Hospital for Children, Denver, CO 80111, USA. steverberg@aol.com
D000293:Adolescent; D001998:Bronchopulmonary Sequestration / Q000401:mortality / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010149:Postoperative Pain / Q000503:physiopathology; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011656:Pulmonary Emphysema / Q000151:congenital / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D014481:United States