TY - JOUR
T1 - Two decades of experience with thoracoscopic lobectomy in infants and children
T2 - Standardizing techniques for advanced thoracoscopic surgery
AU - Rothenberg, Steven S.
AU - Middlesworth, William
AU - Kadennhe-Chiweshe, Angela
AU - Aspelund, Gudrun
AU - Kuenzler, Keith
AU - Cowles, Robert
AU - Bodenstein, Lawrence
AU - Kay, Saundra
AU - Shipman, Kristin
AU - Rothenberg, Cathryn
AU - Stolar, Charles
AU - Stylianos, Steven
N1 - Publisher Copyright:
© 2015, Mary Ann Liebert, Inc.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Objectives: This study evaluates the safety and efficacy of thoracoscopic lobectomy in infants and children. Materials and Methods: From January 1994 to November 2013, 347 patients underwent video-assisted thoracoscopic lobe resection at two institutions. All procedures were performed by or under the direct guidance of a single surgeon. Patients' ages ranged from 1 day to 18 years, and weights ranged from 2.8 to 78?kg. Preoperative diagnosis included sequestration/congenital pulmonary airway malformation (n=306), severe bronchiectasis (n=24), congenital lobar emphysema (n=13), and malignancy (n=4). Results: Of the 347 procedures, 342 were completed thoracoscopically. Operative times ranged from 35 minutes to 240 minutes (average, 115 minutes). Average operative time when a trainee was the primary surgeon was 160 minutes. There were 81 upper, 25 middle, and 241 lower lobe resections. There were four intraoperative complications (1.1%) requiring conversion to an open thoracotomy. The postoperative complication rate was 3.3%, and 3 patients required re-exploration for a prolonged air leak. Hospital length of stay (LOS) ranged from 1 to 16 days (average). In patients <5?kg and <3 months of age, the average operative time was 90 minutes, and the LOS was 2.1 days. Conclusions: Thoracoscopic lung resection is a safe and efficacious technique. With proper mentoring it is an exportable technique, which can be performed by pediatric surgical trainees. The procedures are safe and effective even when performed in the first 3 months of life. Early resection avoids the risk of later infection and malignancy.
AB - Objectives: This study evaluates the safety and efficacy of thoracoscopic lobectomy in infants and children. Materials and Methods: From January 1994 to November 2013, 347 patients underwent video-assisted thoracoscopic lobe resection at two institutions. All procedures were performed by or under the direct guidance of a single surgeon. Patients' ages ranged from 1 day to 18 years, and weights ranged from 2.8 to 78?kg. Preoperative diagnosis included sequestration/congenital pulmonary airway malformation (n=306), severe bronchiectasis (n=24), congenital lobar emphysema (n=13), and malignancy (n=4). Results: Of the 347 procedures, 342 were completed thoracoscopically. Operative times ranged from 35 minutes to 240 minutes (average, 115 minutes). Average operative time when a trainee was the primary surgeon was 160 minutes. There were 81 upper, 25 middle, and 241 lower lobe resections. There were four intraoperative complications (1.1%) requiring conversion to an open thoracotomy. The postoperative complication rate was 3.3%, and 3 patients required re-exploration for a prolonged air leak. Hospital length of stay (LOS) ranged from 1 to 16 days (average). In patients <5?kg and <3 months of age, the average operative time was 90 minutes, and the LOS was 2.1 days. Conclusions: Thoracoscopic lung resection is a safe and efficacious technique. With proper mentoring it is an exportable technique, which can be performed by pediatric surgical trainees. The procedures are safe and effective even when performed in the first 3 months of life. Early resection avoids the risk of later infection and malignancy.
UR - http://www.scopus.com/inward/record.url?scp=84929411295&partnerID=8YFLogxK
U2 - 10.1089/lap.2014.0350
DO - 10.1089/lap.2014.0350
M3 - Article
C2 - 25560086
AN - SCOPUS:84929411295
SN - 1092-6429
VL - 25
SP - 423
EP - 428
JO - Journal of Laparoendoscopic and Advanced Surgical Techniques
JF - Journal of Laparoendoscopic and Advanced Surgical Techniques
IS - 5
ER -