Video-assisted thoracic surgery resection for pediatric mediastinal neurogenic tumors.
OBJECTIVE
Video-assisted thoracoscopic surgery (VATS) resection of mediastinal neurogenic tumors is still controversial in children. The aim of this study was to review the cases of VATS resection of such tumors in children from 3 institutions located in different countries.


METHODS
This retrospective study included 17 children treated between July 1995 and February 2011. Medical charts were reviewed for collection of data on age, sex, histologic type of tumor, clinical manifestations, age and weight at surgery, tumor size, duration of thoracic drainage, surgical complications, tumor recurrence, and mortality.


RESULTS
Thirteen (76.5%) males and 4 (23.5%) females were studied. Median age was 16 months (range, 10.6-60 months), and median weight was 11.9 kg (range, 9.3-27.4 kg). Ten children had neuroblastoma (58.8%), 4 had ganglioneuroma (23.5%), and 3 had ganglioneuroblastoma (17.7%). The median duration of the operation was 90 minutes (range, 45-180 minutes), with complete thoracoscopic resection in all cases. Two children (11.8%) developed Horner syndrome postoperatively. No deaths were reported, and no recurrence was noted during a median follow-up period of 16 months (range, 8.9-28.6 months).


CONCLUSIONS
Video-assisted thoracoscopic surgery resection of mediastinal neurogenic tumors in children produced good results, with no recurrence and minimal postoperative complications. The major advantages of this approach are the avoidance of thoracotomy complications and the enhanced surgical accuracy provided by improved visualization.
Pediatric Thoracic Surgery Unit/Pediatric Surgery Service, Hospital de Clínicas de Porto Alegre, Porto Alegre RS 90035-903, Brazil. jc.fraga@terra.com.br
Jose Carlos
JC
Fraga
Steven
S
Rothenberg
Edward
E
Kiely
Agostino
A
Pierro
D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018305:Ganglioneuroblastoma / Q000601:surgery; D005729:Ganglioneuroma / Q000601:surgery*; D006732:Horner Syndrome / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D008479:Mediastinal Neoplasms / Q000601:surgery*; D009447:Neuroblastoma / Q000601:surgery*; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome