Thoracoscopy in Children

Abstract

Dissatisfied with standard techniques for pulmonary diagnosis in children, we have evaluated the usefulness of thoracoscopy for diagnosis of intrathoracic pathology. Between July 1, 1975, and May 1, 1978, 65 thoracoscopy procedures have been performed in 57 children at the University of Florida. Thirty-four procedures were performed in immunosuppressed patients to rule out Pneumocystis carinii pneumonia. Twenty of these patients were proven to have Pneumocystis pneumonia, a diagnostic accuracy of 100%. Twelve nonimmunosuppressed patients underwent thoracoscopy for the diagnosis of persistent pulmonary infiltrates with a 100% diagnostic accuracy. Fifteen procedures were performed for the diagnosis of intrathoracic tumors. In two patients, previously unsuspected areas of involvement were encountered while in two patients false-negative biopsies were obtained. Four patients underwent therapeutic thoracoscopy. In three small infants, unsuccessful attempts were made to unroof pulmonary cysts through the thoracoscope and one patient underwent a talc poudrage. Thoracoscopy has proven to be a safe and rapid procedure which may be performed under local anesthesia without need for endotracheal intubation. In patients with pulmonary infiltrates, the accuracy has been 100%. The capability of viewing the entire hemithorax has proven valuable in evaluating children with intrathoracic tumors. Complications have included pneumothorax in six patients and bleeding in two.

Video-assisted thoracoscopic lobectomy in infants☆

“…This technique has evolved significantly since the initial descriptions of limited explorations, biopsies, and debridements, made by Rodgers et al [12] in the 1970s. Current studies in the adult population comparing thoracoscopy and thoracotomy highlight the benefits of VATS in terms of morbidity, pain control, hospital stay, and cosmetic result [13].…”

Quantitation of lung sealing in the survival swine model

“…5, 6 Beginning in the late 1970s, thoracoscopy began to be used with increasing frequency in children. 7,8 With the advances in minimally invasive technology of the late 1980s and 1990s, thoracoscopic management of complex surgical procedures became possible. [9][10][11] Stapling devices were first used in thoracic surgery to help seal bronchial stumps.…”

Treatment of a densely fused fissure during thoracoscopic right middle lobectomy

“…Rodgers first reported the use of thoracoscopy in the mid to late 1970s [4,5], and it has come to be used safely and efficiently for treating a number of pulmonary lesions [4] in the pediatric population. Now, thoracoscopic pulmonary lobectomy is performed in all age groups from neonates to adolescents, and is regarded as the treatment of choice at many institutions.…”