Experience with thoracoscopic lobectomy in infants and children.

PURPOSE

This study evaluates the safety and efficacy of thoracoscopic lobectomy in infants and children.

METHODS

From January 1995 to May 2002, 45 patients underwent video-assisted thoracoscopic lobe resection. Ages ranged from 2 days to 18 years and weights from 2.8 to 78 kg. Preoperative diagnosis included sequestration/congenital adenomatoid malformation (n = 28), severe bronchiectasis (n = 12), congenital lobar emphysema (n = 3), and malignancy (n = 2).

RESULTS

Forty-three of 45 procedures were completed thoracoscopically. Operating times ranged from 35 minutes to 210 minutes (average, 125 minutes). There were 6 upper, one middle, and 38 lower lobe resections. There was one intraoperative complication (2.4%) requiring conversion to an open thoracotomy. Chest tubes were left in 38 of 45 patients for 1 to 3 days. Hospital stay ranged from 1 to 5 days (average 2.4).

CONCLUSIONS

Thoracoscopic lung resection is a safe and efficacious technique. It helps avoid the inherent morbidity of a major thoracotomy incision and is associated with the same decrease in postoperative pain, recovery, and hospital stay as seen in minimally invasive procedures.