Does thoracoscopy have advantages over open surgery for asymptomatic congenital lung malformations? An analysis of 1626 resections

Adams, Stephen P.; Jobson, Matthew; Sangnawakij, Patarawan; Heetun, Adam; Thaventhiran, Anthony; Johal, Navroop; Böhning, Dankmar; Stanton, Michael

doi:10.1016/j.jpedsurg.2016.11.014

Cited by 70 publications

(49 citation statements)

References 48 publications

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“…Against this background, the question arises whether VATS lobectomy leads to measurable advantages in pediatric patients? In the review of the literature, a lower complication rate is found for the minimally invasive procedure than in open surgery (6). The average surgery time was longer in the case of thoracoscopic procedures, while the length of stay in the hospital was shorter (6).…”

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confidence: 99%

Minimal-invasive thoracic surgery in pediatric patients

Kügler

2018

J. Vis. Surg.

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During the last two decades, there was a tremendous development of video-assisted thoracoscopic surgery (VATS), especially in the field of video-assisted lung resections. This article describes the actually state of this surgical technique in the treatment of pediatric patients. The problems in practical application are illustrated as well as clinical results, like they are presented in literature.

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confidence: 99%

Minimal-invasive thoracic surgery in pediatric patients

Kügler

2018

J. Vis. Surg.

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“…Hence, bleeding control and parenchyma resection can be performed easily without stretching wound or spreading ribs. The complication rates of VATS resection in children differ in the literature, ranging from 4.4% to 30.6% [30,32]. In this study, the VATS complication rate is 38.5% (5/13).…”

Section: Discussionmentioning

confidence: 54%

“…In the recent two decades, thoracoscopic surgery for paediatric patients has become popular worldwide and even has become a routine procedure for congenital lung malformations [2,6,30]. Metaanalysis reports and retrospective comparative studies indicate that VATS is associated with few complications and short hospital stay [4,6,31,32]. Therefore, the procedure has been proven safe and feasible.…”

Section: Discussionmentioning

confidence: 99%

Uniportal Thoracoscopic Lobectomy for Congenital Lung Malformations in Children

Chou¹,

Huang²,

Yeh³

et al. 2018

J Surg

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Introduction: Single-incision paediatric endosurgery is gaining popularity, especially for abdominal operations. However, few reports in the literature support the feasibility of uniportal thoracoscopic surgery for congenital lung malformations in paediatric patients. This paper presented the initial experience with uniportal thoracoscopic surgery and compared the surgical outcomes with multiport Video-Assisted Thoracoscopic Surgery (VATS) and traditional thoracotomy. Materials and Methods: From January 2009 to January 2018, a retrospective review of all patients (less than 18 years old) who underwent surgery for congenital lung malformations at our institution was performed. General data, operative data, anaesthesia parameters and surgical outcomes were collected. Results were analysed with one-way ANOVA and chi-square tests for continuous and categorical data. Results: Twenty-one patients with congenital lung malformations underwent surgery at our institution. The number of patients enrolled in thoracotomy, multiportal VATS and uniportal VATS groups was 8, 6 and 7, respectively. No difference in age, body weight, post-operative stay and drainage period was observed among the groups. A considerably high conversion rate (3/6, 50%) was observed in the multiportal VATS group. After the introduction of endobronchial blocker for one lung ventilation, all multi-portal and uniportal VATS procedures could be performed safely without residual lesion or mortality. Conclusions: VATS is feasible in the paediatric population, and it needs experienced surgical skills and unique anaesthetic requirements. For small infants with congenital lung malformations, uniportal VATS with endobronchial blocker is preferred.

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“…They concluded that thoracoscopic resection is not associated with more risks than open surgery. 10 All of the above-mentioned studies included children from different age groups. As feasibility of pulmonary VATS in neonates and infants up to the age of 12 months has not been investigated systematically, we reviewed the available data in the current literature.…”

Section: Introductionmentioning

confidence: 99%

Perioperative Complications of Video-Assisted Thoracoscopic Pulmonary Procedures in Neonates and Infants

2018

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Video-assisted thoracoscopic surgery (VATS) has gained broad acceptance among pediatric surgeons. Today, VATS can be regarded as a routine approach for various conditions in neonates and infants. However, there is a lack of information concerning the complications of thoracoscopic pulmonary surgery in neonates and infants. We aimed to review the available data. A systematic review of the literature was performed using PubMed. All publications reporting on VATS for pulmonary procedures in neonates and infants up to the age of 1 year were included. Articles were reviewed in detail for occurrence of perioperative complications and their treatment. Nine case series were eligible for analysis. Entities treated included lung sequestration, congenital pulmonary airway malformation, congenital lobar emphysema, and bronchogenic cyst. Case series reported on a total number of 135 patients. Complications occurred in 14 patients (10.4%). The major complication was an accidental transection of the middle lobar bronchus that concluded in a later resection of a prior unaffected lung lobe. Other relevant complications reported were bleeding in four patients (3.0%) and persistent air leak in four cases (3.0%). Infectious complications were reported in four patients (3.0%). Additionally, iatrogenic phrenic nerve paralysis occurred in one patient. There were no deaths related to the VATS technique. In 11 cases (8.1%), conversion to thoracotomy had been necessary. General recommendations on the treatment of complications could not be derived due to small patient numbers and lack of details of the complications reported. Reports on major complications of pulmonary VATS in neonates and infants below 1 year of age are scarce. As severe complications such as accidental bronchus transection have been described, feasibility of neonatal/infant VATS cannot be unequivocally confirmed. No literature-based recommendation can be given on the treatment of complications.

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Does thoracoscopy have advantages over open surgery for asymptomatic congenital lung malformations? An analysis of 1626 resections

Abstract: 4 (based on lowest level of article analyzed in meta-analysis/systematic review).

Cited by 70 publications

References 48 publications

Minimal-invasive thoracic surgery in pediatric patients

Minimal-invasive thoracic surgery in pediatric patients

Uniportal Thoracoscopic Lobectomy for Congenital Lung Malformations in Children

Perioperative Complications of Video-Assisted Thoracoscopic Pulmonary Procedures in Neonates and Infants

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