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[Thoracoscopic lung resection in children]
A Iu Razumovskiĭ1, O G Mokrushina1, A B Alkhasov1
1Chair of Pediatric Surgery of N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow; N.F. Filatov Children's City Clinical Hospital #13, Moscow Department of Health, Russia.
Insights
Thoracoscopic lung resection is a safe and effective treatment for congenital lung disease in infants. This minimally invasive approach leads to better postoperative outcomes and shorter hospital stays for young patients.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Congenital Malformations
Background:
- Congenital lung diseases are a primary cause of pulmonary surgical pathology in newborns and infants.
- Surgical intervention is the definitive treatment for these conditions.
- The N.F. Filatov City Children's Hospital has extensive experience with over 1000 endoscopic thoracic operations, including more than 300 lung resections.
Purpose of the Study:
- To analyze the treatment outcomes of 194 infants with congenital lung disease between 2005 and 2014.
- To evaluate the efficacy and safety of thoracoscopic lung resection in this pediatric population.
Main Methods:
- Retrospective analysis of treatment results for 194 infants with congenital lung disease.
- Surgical procedures included urgent operations, operations for compensated respiratory failure, and elective procedures for asymptomatic cases.
- Thoracoscopic lobectomy was the predominant surgical technique.
Main Results:
- 14% of patients required urgent surgery, and 12% underwent surgery for compensated respiratory failure at a young age.
- Elective thoracoscopic lung resection was performed on asymptomatic children between 3 and 8 months.
- Thoracoscopic lobectomy accounted for 62% of procedures, with no intraoperative complications reported.
Conclusions:
- Thoracoscopic lung resection is the preferred surgical method for congenital lung malformations in newborns and infants.
- This technique offers improved intraoperative visualization and precise dissection, leading to better postoperative recovery and reduced hospital stays.
Abstract:
The spectrum of pulmonary surgical pathology in newborns and infants is mainly presented by congenital diseases. Surgery is the main radical method of treatment of children with congenital lung diseases. By this time in the N.F.Filatov City Children's Hospital No13 it is performed more than 1000 endoscopic operations on the thoracic cavity including more than 300 lung resections. More than 190 cases were caused by congenital lung disease. The results of treatment of 194 infants with congenital lung disease for the period 2005-2014 are analyzed in this article. 14 (22%) patients were operated urgently. 8 patients (12%) with compensated respiratory failure underwent surgery at the age of 8 to 46 days. Children with absence of clinical manifestations underwent thoracoscopic lung resection at the age of 3 to 8 months. Thoracoscopic lobectomy was performed in the 40 cases (62%). There were no intraoperative complications. Thoracoscopic lung resection for malformations in newborns and infants is currently the method of choice. It allows to visualize pathological focus intraoperatively and to perform precise dissection of pulmonary root structures using modern equipment. Thus, it improves course of postoperative period and reduces duration of hospital-stay. Repeated lung resection in patients with recurrent tuberculosis of operated lung (literature review and own data).
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