Gilbert J C, Powell D M, Hartman G E, Seibel N L, Newman K D
Department of Surgery, Children's National Medical Center, Washington, DC 20010, USA.
Ann Surg Oncol. 1996 Nov;3(6):539-42. doi: 10.1007/BF02306086.
Video-assisted thoracic surgery (VATS) may complement open thoracotomy in children with osteosarcoma requiring pulmonary metastasectomy.
The records of children with metastatic pulmonary osteosarcoma considered for initial VATS intervention (n = 9) were reviewed.
Two children did not have VATS exploration: one child with multiple bilateral nodules and another child with a deep parenchymal nodule. VATS provided diagnostic biopsy material in all cases when used (n = 7). Two children had benign inflammatory lesions; four children had VATS-directed wedge resections of solitary malignant lesions; and one child had VATS biopsy of diffuse parenchymal and pleural pulmonary disease not amenable to resection. The mean operative time and hospital length of stay were 1.78 +/- 0.54 h and 3.5 +/- 1.8 days, respectively. There were two complications of VATS: bleeding in a child, requiring a transfusion, and a latent pneumothorax in a patient after removal of the chest tube.
VATS is safe, serves as an excellent diagnostic modality, complements the open thoracotomy, and may enable the surgeon to avoid more extensive procedures in selected cases.
对于需要进行肺转移瘤切除术的骨肉瘤患儿，电视辅助胸腔镜手术（VATS）可作为开胸手术的补充。
回顾了考虑进行初次VATS干预的转移性肺骨肉瘤患儿（n = 9）的记录。
两名患儿未进行VATS探查：一名患儿有多个双侧结节，另一名患儿有一个深部实质结节。在所有使用VATS的病例中（n = 7）均获取了诊断性活检材料。两名患儿有良性炎性病变；四名患儿接受了VATS引导下的孤立性恶性病变楔形切除术；一名患儿接受了VATS对无法切除的弥漫性实质和胸膜肺部疾病的活检。平均手术时间和住院时间分别为1.78 +/- 0.54小时和3.5 +/- 1.8天。VATS有两种并发症：一名患儿出血，需要输血，另一名患者拔除胸管后出现潜在气胸。
VATS是安全的，是一种出色的诊断方式，可作为开胸手术的补充，并且在某些病例中可能使外科医生避免进行更广泛的手术。
