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Published on: June 20, 2018
Thoracoscopic surgery in children in the Kyushu area of Japan
Koushi Asabe1, Yoichiro Oka, Hiroki Kai
1Department of Surgery, Division of Thoracic, Endocrine and Pediatric Surgery, Fukuoka University School of Medicine, Fukuoka, Japan. asabe@ fukuoka-u.ac.jp
Insights
Minimally invasive thoracoscopic surgery is a safe and effective diagnostic and therapeutic tool for pediatric patients under 15. This review of chest procedures in Japan found no mortality and few complications.
Area of Science:
- Pediatric Surgery
- Thoracoscopic Surgery
- Minimally Invasive Procedures
Background:
- Minimally invasive thoracoscopic surgery offers diagnostic and treatment options in pediatric surgery.
- This study reviews surgical experience to assess problems and complications in children under 15 undergoing thoracoscopic surgery in Japan.
Purpose of the Study:
- To evaluate the safety and efficacy of thoracoscopic surgery in pediatric patients.
- To identify complications and challenges associated with thoracoscopic procedures in children.
Main Methods:
- A retrospective review of 256 patients (153 boys, 103 girls) aged under 15 who underwent thoracoscopic surgery between 1993 and 2005.
- Data collected included patient demographics, indications for surgery, procedures performed, follow-up duration, reasons for conversion to thoracotomy, and complications.
Main Results:
- The number of annual thoracoscopic operations increased over time.
- Common procedures included surgery for funnel chest (n=121), pneumothorax (n=25), mediastinal tumors (n=25), palmar hyperhidrosis (n=23), neuroblastoma (n=11), and cystic lung disease (n=10).
- Three patients required conversion to thoracotomy, and six complications occurred, with no associated mortality.
Conclusions:
- Thoracoscopy is a valuable diagnostic and therapeutic tool for infants and children.
- Complex thoracoscopic procedures can be performed safely and effectively in pediatric patients.
Background:
Recently, minimally invasive thoracoscopic surgery has offered several options for both the diagnosis and surgical treatment in the field of pediatric surgery. This report reviews the surgical experience in order to assess the problems including the complications, encountered during thoracoscopic surgery in children under 15 years of age in the Kyushu area, Japan.
Methods:
From 1993 to 2005, 153 boys and 103 girls underwent thoracoscopic surgery for chest disease. Pertinent information included number of operations for each year, sex, age, indication, treatment procedure, follow-up duration, cause of conversion to thoracotomy, method of treatment, and complication.
Results:
There has gradually been an increase in the number of operations every year. These included procedures for funnel chest, n= 121; pneumothorax, n= 25; mediastinal tumor, n= 25; palmar hyperhydrosis, n= 23; neuroblastoma, n= 11; and cystic lung disease, n= 10. A large portion of the surgery was for patients under 1 year of age excluding neonates. Approximately half of the procedures were for the excision of a neuroblastoma. Approximately half of the patients older than 5 years of age underwent Nuss procedure for funnel chest. Almost all of the pneumothorax and palmar hyperhydrosis surgery was for patients 14 or 15 years old. Three patients required a conversion to a standard thoracotomy. Six complications occurred. There was no mortality associated with the thoracoscopic surgical procedures.
Conclusions:
Thoracoscopy is a useful diagnostic and therapeutic tool for both infants and children. Various thoracoscopic complex procedures have been performed both safely and effectively.
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