Thoracoscopic upper lobectomies for symptomatic congenital lung cysts

Thoracoscopic lobectomy is increasingly employed for congenital pulmonary malformations in children. Upper lobectomy is considered more technically challenging than lower lobectomy due to the more variable anatomy of the upper lobes and the need for more extensive dissection. Detailed techniques for thoracoscopic upper lobectomies have, therefore, not been as evident. This report and the accompanying video describe thoracoscopic techniques for the right left upper lobectomy in children. A thoracoscopic right upper lobectomy was performed in a 21-month-old girl. A thoracoscopic left upper lobectomy was performed in a 12-year-old boy. Both patients presented with infected cystic malformations. The procedures were performed after successful antibiotic therapy and a complete resolution of the pneumonia. Excellent outcomes were achieved in both cases. Thoracoscopic upper lobectomies can be safely and successfully performed in children with congenital cystic malformations, even after episodes of significant infection.