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Extrapleural pneumonectomy in children.

Raja M Flores1, Wendy Su, Dave Lal

  • 1Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. floresr@mskcc.org

Journal of Pediatric Surgery
|October 3, 2006
PubMed
Summary
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Extrapleural pneumonectomy (EPP) is a surgical procedure for pediatric pleural malignancies. EPP can be curative in selected children, but further studies are needed.

Area of Science:

  • Pediatric Thoracic Surgery
  • Pediatric Oncology
  • Surgical Oncology

Background:

  • Extrapleural pneumonectomy (EPP) involves en bloc resection of the pleura, lung, diaphragm, and pericardium.
  • EPP in pediatric patients has not been previously reported.
  • This study addresses the use of EPP in children with pleural surface malignancies.

Purpose of the Study:

  • To report the experience of using Extrapleural pneumonectomy (EPP) in pediatric patients.
  • To evaluate the efficacy of EPP in treating pediatric malignancies involving the pleural surface.

Main Methods:

  • Retrospective review of pediatric patients treated with EPP.
  • Data collected from patient charts and a pediatric database.
  • All patients underwent en bloc resection and reconstruction.

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Main Results:

  • Four pediatric patients (ages 6-11) underwent EPP for various malignancies (inflammatory myofibroblastic tumor, spindle cell sarcoma, neuroblastoma, mesothelioma).
  • Two patients achieved disease-free status post-EPP.
  • Two patients experienced disease recurrence or progression, leading to mortality.

Conclusions:

  • Extrapleural pneumonectomy (EPP) is a viable option for selected pediatric patients with pleural-based malignancies.
  • EPP should be considered by pediatric thoracic surgeons for these cases.
  • Larger studies are recommended to further evaluate EPP in pediatric populations.