Video-assisted thoracoscopic surgery for primary spontaneous pneumothorax in children

Abstract

VATS is a safe and effective procedure for PSP in children. However, the risk of recurrence is increased in children and it is related to the formation of new bullae.

What Factors Predict Recurrence after an Initial Episode of Primary Spontaneous Pneumothorax in Children?

“…Therefore, most patients with air-containing lesions on HRCT scans or chest X-rays request early VATS to achieve early discharge and a lower chance of recurrence. In our previous study, the mean postoperative pleural drainage duration was 3.2 days, 16) which was similar to the duration of conservative treatment. VATS is safe and is the most effective treatment method for PSP in children.…”

“…In fact, VATS is associated with lower morbidity, decreased pain, and shorter hospital stays. 5,[14][15][16] Considering the higher rate of recurrence, especially in paediatric PSP, determining the predictive factors of recurrence could be useful for selecting patients who may benefit from early surgical referral to prevent recurrence and reduce hospital stays.…”

“…VATS is safe and is the most effective treatment method for PSP in children. 5,6,[14][15][16] Some authors have recommended that preventive VATS may be considered if air-containing lesions are detected on initial HRCT scans. 6,17) However, this surgical approach for air-containing lesions to prevent recurrence has two major problems.…”

“…Second, postoperative recurrence in children was reported to be slightly higher than in adults. 5,14,16,26) …”

Minimally Invasive Thoracic Surgery in Pediatric Patients: The Taiwan Experience

“…Currently, video-assisted thoracoscopy (VATS) has become an increasingly important tool in pediatric surgery. It has been mainly used for lung biopsy and for the treatment of empyema and recurrent pneumothorax [7–9]. Several published reports suggest thoracoscopic pulmonary resections, including segmentectomy and lobectomy is safe, with the potential advantage of shorter hospital stay, quicker recovery, and better cosmetic result treatment modality [10–12].…”