title: Thoracoscopic division of vascular rings.
abstract: OBJECTIVE
  Vascular rings are traditionally treated via an open thoracotomy. In recent years the use of thoracoscopy has increased. Herein we report our experience with thoracoscopic division of vascular rings in pediatric patients.
  
  
  METHODS
  We reviewed all patients who underwent thoracoscopic or open division of a vascular ring at our institution between 2007 and 2015. We analyzed patient demographics, presenting symptoms, diagnostic imaging modality, ring anatomy, operative details, complications, and symptom resolution.
  
  
  RESULTS
  Thirty-one patients underwent thoracoscopic division of a vascular ring while sixteen had open operations. Median age was 24months in the thoracoscopic group and 13months in the open group. Operative time averaged 74min (thoracoscopic) and 95min (open). There were no mortalities at 30days. There was complete symptom resolution in 71% of thoracoscopic patients and 63% of open. Patients in the thoracoscopic group had decreased ICU admissions (10% vs. 94%), chest tube use (62% vs. 100%), chylothorax (6% vs. 38%) and overall length of stay (1.7days vs. 5days).
  
  
  CONCLUSIONS
  Thoracoscopic division of vascular rings in pediatric patients is a feasible alternative to open division and is associated with comparable rates of symptom resolution and decreased length of hospital stay and chylothorax.
  
  
  METHODS
  III.
authors.affiliation: Division of General and Thoracic Surgery, Seattle Children's Hospital and University of Washington, Seattle, WA 98105, USA.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Riggle
authors.affiliation: Division of General and Thoracic Surgery, Seattle Children's Hospital and University of Washington, Seattle, WA 98105, USA.
authors.forename: Samuel E
authors.initials: SE
authors.lastname: Rice-Townsend
authors.affiliation: Division of General and Thoracic Surgery, Seattle Children's Hospital and University of Washington, Seattle, WA 98105, USA. Electronic address: john.waldhausen@seattlechildrens.org.
authors.forename: John H T
authors.initials: JHT
authors.lastname: Waldhausen
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D013906:Thoracoscopy; D013908:Thoracotomy; D016896:Treatment Outcome; D000073872:Vascular Ring / Q000601:surgery*
keywords: Pediatric; Thoracoscopy; Vascular ring