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Clinical practice of video-assisted thoracoscopic surgery in children
Zheng Wang1, Zheng Zhang, Chao Yang
1Department of Thoracic Surgery Second Affiliated Hospital, Medical College of Ji'nan University, Shenzhen 518020, China.
Insights
Video-assisted thoracoscopic surgery (VATS) is a safe and effective treatment for pediatric chest diseases. This minimally invasive approach offers good outcomes for various thoracic conditions in children.
Area of Science:
- Pediatric Thoracic Surgery
- Minimally Invasive Surgery
- Diagnostic Procedures
Background:
- Chest diseases in children require effective diagnostic and therapeutic interventions.
- Traditional thoracotomy can be invasive for pediatric patients.
Purpose of the Study:
- To evaluate the efficacy and safety of video-assisted thoracoscopic surgery (VATS) in diagnosing and treating pediatric chest diseases.
- To assess the outcomes of VATS in a cohort of children with various thoracic conditions.
Main Methods:
- Retrospective analysis of 41 children (average age 6.9 years) who underwent VATS between May 1997 and October 2001.
- Procedures included empyema management, tumor biopsy/resection, lung cyst resection, and diaphragmatic hernia repair.
- Data collected on operative time, blood loss, chest drainage duration, hospital stay, and postoperative morbidity.
Main Results:
- Mean operative time was 74 minutes with minimal blood loss (33 ml).
- Average chest drainage was 2.4 days and hospital stay was 7.0 days.
- Postoperative morbidity was 7.3% (3 patients); 38 out of 40 followed patients developed normally.
Conclusions:
- Video-assisted thoracoscopic surgery (VATS) is a safe and effective diagnostic and therapeutic option for children with chest diseases.
- VATS plays a significant role in pediatric thoracic surgery, offering good outcomes and a low complication rate.
Abstract:
OBJECTIVE To estimate the value of video-assisted thoracoscopic surgery (VATS) in diagnosis and treatment of children with chest diseases. METHODS From May 1997 to October 2001, forty-one children (25 boys and 16 girls) with chest diseases received VATS under general anesthesia in our hospital. Their average age was 6.9 years (range 9 days to 16 years) and their median body weight was 22.5 kg (2.8-54.0 kg). Operative procedures included fibrinopurulent empyema with debridement and decortication in 15 children, biopsy and(or) resection of mediastinal tumor in 11, bullectomy and cystectomy of the lung in 6, lobectomy with huge cyst of the lung or sequestration in 5, clearance of hemothorax in 2, and exploration, and repair of diaphragmatic hernia in 2. RESULTS The mean operative time was 74 minutes (range 30 to 220 minutes). The lost blood volume was 33 ml (range 10 to 150 ml). The mean duration of chest drainage and hospital stay after surgery was 2.4 days and 7.0 days (range 4 to 15 days) respectively. One infant born after 9 days with congenital diaphragmatocele died of respiratory failure due to left pulmonary hypoplasia 10 days after operation. Postoperative morbidity was 7.3% (3 patients). Forty patients were followed up for an average of 15.6 months, 38 patients lived and developed normally, and 2 received chemotherapy. CONCLUSION Video-assisted thoracoscopy is a safe and effective diagnostic and therapeutic procedure for children with chest disease, and this approach has an important place in pediatric thoracic surgery.