title: Use of the harmonic blade scalpel as a novel technique for thoracoscopic resection of pediatric paraspinal masses in children.
abstract: BACKGROUND
  Data support use of video-assisted thoracoscopic surgery (VATS) for safe and effective resection of paraspinal masses in children. Our aim was to describe outcomes following this operation using a novel technique and to compare its use with that of other established techniques.
  
  
  METHODS
  We performed a retrospective chart review of all children (<18 years old) undergoing thoracoscopic resection of paraspinal masses in 2000-2011. Demographics, operative details, and clinical outcomes were summarized and compared between those undergoing resection using a Harmonic (Ethicon Endo-Surgery, Blue Ash, OH) blade scalpel (HBS) and those who did not.
  
  
  RESULTS
  Sixteen cases were identified (median age, 57.5 months; range, 2-204 months). Six cases (37%) underwent VATS with use of the HBS, and 10 (63%) did not. Demographic and clinical factors were well matched. Median tumor diameter was larger in the HBS group (49.2 cm(3) versus 18.7 cm(3); P=.07). Operative time was similar between groups (121 versus 138 minutes; P=.25), as was the estimated blood loss (10 mL versus 30 mL; P=.91) and chest tube duration (2.1 versus 1.8 days; P=.78). Three cases of Horner's syndrome developed in the standard resection group, and one complication occurred in the HBS group.
  
  
  CONCLUSIONS
  The Harmonic blade scalpel can be used as a simple alternative to standard dissection techniques for thoracoscopic resection of paraspinal masses in children.
authors.affiliation: 1 Department of Pediatric Surgery, Children's Hospital Los Angeles , Los Angeles, California.
authors.forename: Scott S
authors.initials: SS
authors.lastname: Short
authors.forename: Bindi J
authors.initials: BJ
authors.lastname: Naik-Mathuria
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Hunter
authors.forename: Stephanie
authors.initials: S
authors.lastname: Papillon
authors.forename: James E
authors.initials: JE
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004564:Electrocoagulation; D005260:Female; D005500:Follow-Up Studies; D018305:Ganglioneuroblastoma / Q000601:surgery; D005729:Ganglioneuroma / Q000601:surgery; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D018302:Neoplasms, Neuroepithelial / Q000601:surgery*; D009442:Neurilemmoma / Q000601:surgery; D009447:Neuroblastoma / Q000601:surgery; D018241:Neuroectodermal Tumors, Primitive, Peripheral / Q000601:surgery*; D009456:Neurofibromatosis 1 / Q000601:surgery; D064170:Paraspinal Muscles; D012189:Retrospective Studies; D018335:Rhabdoid Tumor; D013899:Thoracic Neoplasms / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000295:instrumentation* / Q000379:methods*