The first 100 infant thoracoscopic lobectomies: Observations through the learning curve and comparison to open lobectomy

Laje, Pablo; Pearson, Erik G.; Simpao, Allan F.; Rehman, Mohammed A.; Sinclair, Tiffany J.; Hedrick, Holly L.; Adzick, N. Scott; Flake, Alan W.

doi:10.1016/j.jpedsurg.2015.05.015

Cited by 28 publications

(34 citation statements)

References 21 publications

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“…Length of hospital stay was described in 17 NRSs, comparing a total of 3,726 patients. [47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63] Of these eight (41.2%) including 302 patients (8.1%) showed a shorter stay for thoracoscopic lung resections. [48][49][50][51][52][53]61 This finding was confirmed in both MAs (evidence level 3a).…”

Section: Advantages Of Vatsmentioning

confidence: 99%

Video-Assisted Thoracoscopic or Conventional Thoracic Surgery in Infants and Children: Current Evidence

et al. 2020

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Introduction The pros and cons of video-assisted thoracoscopic versus conventional thoracic surgery in infants and children are still under debate. We assessed reported advantages and disadvantages of video-assisted thoracoscopy in pediatric surgical procedures, as well as the evidence level of the available data. Materials and Methods A systematic literature search was performed to identify manuscripts comparing video-assisted thoracoscopic and the respective conventional thoracic approach in classic operative indications of pediatric surgery. Outcome parameters were analyzed and graded for level of evidence (according to the Oxford Centre of Evidence-Based Medicine). Results A total of 48 comparative studies reporting on 12,709 patients, 11 meta-analyses, and one pilot randomized controlled trial including 20 patients were identified. More than 15 different types of advantages for video-assisted thoracoscopic surgery were described, mostly with a level of evidence 3b or 3a. Most frequently video-assisted thoracoscopic surgery was associated with shorter hospital stay, shorter postoperative ventilation, and shorter time to chest drain removal. Mortality rate and severe complications did not differ between thoracoscopic and conventional thoracic pediatric surgery, except for congenital diaphragmatic hernia repair with a lower mortality and higher recurrence rate after thoracoscopic repair. The most frequently reported disadvantage for video-assisted thoracoscopic surgery was longer operative time. Conclusion The available data point toward improved recovery in pediatric video-assisted thoracoscopic surgery despite longer operative times. Further randomized controlled trials are needed to justify the widespread use of video assisted thoracoscopy in pediatric surgery.

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Section: Advantages Of Vatsmentioning

confidence: 99%

Video-Assisted Thoracoscopic or Conventional Thoracic Surgery in Infants and Children: Current Evidence

et al. 2020

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“…large single-center reports [39] as well as large administrative and clinical database studies [40,41].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Birth historyThe median gestational age at birth was39.0 weeks [interquartile range (IQR), 37.0-39.2]. The median birth weight was 3.2 kg (IQR, 2.8-3.6).…”

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confidence: 99%

Development of a multi-institutional registry for children with operative congenital lung malformations

Kunisaki

Saito

Fallat

et al. 2020

Journal of Pediatric Surgery

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Introduction: The purpose of this study was to develop a multi-institutional registry to characterize the demographics, management, and outcomes of a contemporary cohort of children undergoing congenital lung malformation (CLM) resection. Methods: After central reliance IRB approval, a web-based, secure database was created to capture retrospective cohort data on pathologically-confirmed CLMs performed between 2009-2015 within a multi-institutional research collaborative. Results: Eleven children's hospitals contributed 506 patients. Among 344 prenatally diagnosed lesions, the congenital pulmonary airway malformation volume ratio was measured in 49.1%, and fetal MRI was performed in 34.3%. One hundred thirty-four (26.7%) children had respiratory symptoms at birth. Fifty-eight (11.6%) underwent neonatal resection, 322 (64.1%) had surgery at 1-12 months, and 122 (24.3%) had operations after 12 mos. The median age at resection was 6.7 months (interquartile range, 3.6-11.4). Among 230 elective lobectomies performed in asymptomatic patients, thoracoscopy was successfully utilized in 102 (44.3%), but there was substantial variation across centers. The most common lesions were congenital pulmonary airway malformation (n=234, 47.3%) and intralobar bronchopulmonary sequestration (n=106, 21.4%). Conclusion: This multicenter cohort study on operative CLMs highlights marked disease heterogeneity and substantial practice variation in preoperative evaluation and operative management. Future registry studies are planned to help establish evidencebased guidelines to optimize the care of these patients.

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“…Since the first reports on the use of thoracoscopy for congenital anomalies in infants, this surgical approach has been shown to be effective, safe, and to result in better cosmetic outcome in comparison to open surgery . However, intraoperative acidosis and hypercapnia during thoracoscopy have been reported in some retrospective studies in the pediatric age group and have been confirmed by a pilot randomized controlled trial in neonates undergoing thoracoscopic repair of congenital diaphragmatic hernia (CDH) or esophageal atresia/trachea‐esophageal fistula (EA/TEF) .…”

Section: Introductionmentioning

confidence: 99%

Intraoperative acidosis and hypercapnia during thoracoscopic repair of congenital diaphragmatic hernia and esophageal atresia/tracheoesophageal fistula

Zani

Lamas-Pinheiro

Paraboschi

et al. 2017

Pediatric Anesthesia

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What is already known• Thoracoscopy in neonates is known to be associated with intraoperative acidosis and hypercapnia. What this article adds• Thoracoscopic repair of CDH or EA/TEF may result in more severe intraoperative acidosis and hypercapnia than during open surgery. Conclusions.Neonates undergoing operative repair of CDH or EA/TEF develop intraoperative acidosis and hypercapnia, regardless of the approach used. However, this phenomenon is more severe during thoracoscopic repair. Novel modalities to reduce intraoperative gas derangements, particularly during thoracoscopic repair, need to be established.

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The first 100 infant thoracoscopic lobectomies: Observations through the learning curve and comparison to open lobectomy

Cited by 28 publications

References 21 publications

Video-Assisted Thoracoscopic or Conventional Thoracic Surgery in Infants and Children: Current Evidence

Video-Assisted Thoracoscopic or Conventional Thoracic Surgery in Infants and Children: Current Evidence

Development of a multi-institutional registry for children with operative congenital lung malformations

Intraoperative acidosis and hypercapnia during thoracoscopic repair of congenital diaphragmatic hernia and esophageal atresia/tracheoesophageal fistula

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