title: [Thoracoscopic lobectomy: initial experience].
abstract: OBJECTIVE
  Analizing our preliminary experience in the treatment of pulmonary malformations with thoracoscopic lobectomy.
  
  
  METHODS
  We have reviewed our first cases of thoracoscopic lobectomy during last year (2008-09). We have performed 6 thoracoscopic lobectomies in 6 male patients with a mean age of 16 months (6 months-4 years). They were 3 lower lobectomies (2 right and one left), 2 right upper lobectomies and one lingular sparing left upper lobectomy. Lung lesion was a congenital cystic adenomatoid malformation in 5 (2 of them asociated with intralobar sequestration) and one lobar emphysema due to bronquial atresia.
  
  
  RESULTS
  Selective bronchial intubation was used in 4 cases and and tracheal intubation with bronchial blocker in 2. There were no conversions to open thoracotomy. Mean operative time was 202' (155-250'). There were no intraoperative nor postoperative complications. None of these patients needed blood transfusion. Mean drainage time was 3.5 days (3-4 d) and mean discharge time was 4.8 days (4-7 d). With a mean follow-up time of 5.3 months (2 m-12 m), all of the patients have no symptoms and X-ray are normal.
  
  
  CONCLUSIONS
  Thoracoscopic lobectomy is a safe and efective approach to treat congenital pulmonary pathology. The keys to perform it safely are good anesthetic management, adequate instruments for children size, and careful disection of broncovascular structures. Advantages of the minimal access surgery and implementation and miniaturization of the instruments and sealing devices will favor its progressive use.
authors.affiliation: Servei de Cirurgia Pediàtrica, Agrupació Sanitaria Hospital Sant Joan de Déu-Hospital Clínic, Universitat de Barcelona. xtarrado@hsjdbcn.org
authors.forename: X
authors.initials: X
authors.lastname: Tarrado
authors.forename: M
authors.initials: M
authors.lastname: Castañón
authors.forename: M
authors.initials: M
authors.lastname: Olivares
authors.forename: B
authors.initials: B
authors.lastname: García-Núñez
authors.forename: M
authors.initials: M
authors.lastname: Vancells
authors.forename: E
authors.initials: E
authors.lastname: Muñoz
authors.forename: J M
authors.initials: JM
authors.lastname: Ribó
mesh_terms: D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008168:Lung / Q000002:abnormalities* / Q000601:surgery*; D008297:Male; D011013:Pneumonectomy / Q000379:methods*; D012189:Retrospective Studies; D013906:Thoracoscopy