Video-assisted thoracoscopic versus open surgery for persistent ductus arteriosus

Area of Science:

• Pediatric Surgery
• Thoracic Surgery
• Minimally Invasive Surgery

Background:

• Patent ductus arteriosus (PDA) is a common congenital heart defect.
• Traditional surgical management involves open thoracotomy and ligation.
• Advancements in minimally invasive techniques offer potential benefits.

Purpose of the Study:

• To compare the outcomes of video-assisted thoracoscopic surgery (VATS) for PDA ligation with conventional open surgery.
• To evaluate the safety and efficacy of VATS in pediatric patients with PDA.

Main Methods:

• Retrospective review of 60 children undergoing open PDA ligation (1986-1995).
• Prospective data collection for 50 children undergoing VATS PDA ligation (since 1995).
• Comparison of operative time, complications, and recovery metrics.

Main Results:

• All patients survived; no significant difference in major complications requiring reoperation.
• VATS group demonstrated significantly shorter operative time, hospital stay, and recovery periods.
• VATS group experienced higher rates of recurrent laryngeal nerve injury and chylothorax.

Conclusions:

• VATS PDA ligation is a viable alternative to open surgery, offering faster recovery and shorter hospitalizations.
• Increased vigilance for specific complications, such as recurrent laryngeal nerve injury, is warranted with VATS.
• Both surgical approaches provide comparable long-term outcomes for PDA management.