Short Scott S, Naik-Mathuria Bindi J, Hunter Catherine J, Papillon Stephanie, Stein James E
1 Department of Pediatric Surgery, Children's Hospital Los Angeles , Los Angeles, California.
J Laparoendosc Adv Surg Tech A. 2014 Apr;24(4):274-9. doi: 10.1089/lap.2013.0394.
Data support use of video-assisted thoracoscopic surgery (VATS) for safe and effective resection of paraspinal masses in children. Our aim was to describe outcomes following this operation using a novel technique and to compare its use with that of other established techniques.
We performed a retrospective chart review of all children (<18 years old) undergoing thoracoscopic resection of paraspinal masses in 2000-2011. Demographics, operative details, and clinical outcomes were summarized and compared between those undergoing resection using a Harmonic (Ethicon Endo-Surgery, Blue Ash, OH) blade scalpel (HBS) and those who did not.
Sixteen cases were identified (median age, 57.5 months; range, 2-204 months). Six cases (37%) underwent VATS with use of the HBS, and 10 (63%) did not. Demographic and clinical factors were well matched. Median tumor diameter was larger in the HBS group (49.2 cm(3) versus 18.7 cm(3); P=.07). Operative time was similar between groups (121 versus 138 minutes; P=.25), as was the estimated blood loss (10 mL versus 30 mL; P=.91) and chest tube duration (2.1 versus 1.8 days; P=.78). Three cases of Horner's syndrome developed in the standard resection group, and one complication occurred in the HBS group.
The Harmonic blade scalpel can be used as a simple alternative to standard dissection techniques for thoracoscopic resection of paraspinal masses in children.
数据支持使用电视辅助胸腔镜手术（VATS）安全有效地切除儿童脊柱旁肿块。我们的目的是描述采用一种新技术进行该手术后的结果，并将其与其他成熟技术的使用情况进行比较。
我们对2000年至2011年间所有接受胸腔镜切除脊柱旁肿块的18岁以下儿童进行了回顾性病历审查。总结并比较了使用超声刀（爱惜康内镜外科公司，俄亥俄州蓝灰市）手术刀（HBS）进行切除的患者与未使用该器械患者的人口统计学资料、手术细节和临床结果。
共确定16例病例（中位年龄57.5个月；范围2至204个月）。6例（37%）使用HBS进行了VATS，10例（63%）未使用。人口统计学和临床因素匹配良好。HBS组的肿瘤中位直径更大（49.2 cm³对18.7 cm³；P = 0.07）。两组的手术时间相似（121对138分钟；P = 0.25），估计失血量（10 mL对30 mL；P = 0.91）和胸管留置时间（2.1对1.8天；P = 0.78）也相似。标准切除组发生3例霍纳综合征，HBS组发生1例并发症。
超声刀可作为儿童胸腔镜切除脊柱旁肿块的标准解剖技术的一种简单替代方法。
