Efficacy of primary and secondary video-assisted thoracic surgery in children

Frederick Rescorla, Karen W. West, Cynthia A. Gingalewski, Scott A. Engum, L. R. Scherer, Jay L. Grosfeld

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Background/Purpose: Video-assisted thoracic surgery (VATS) is used commonly for diagnostic and therapeutic procedures in children. The purpose of this study was to determine the accuracy, efficacy, and complications associated with primary and secondary VATS in children. Methods: Eighty-seven infants, children, and adolescents underwent 104 VATS procedures between March 1993 and April 1999. There were 47 boys and 40 girls with an age range of 6 months to 19 years. VATS was performed for excision of pulmonary nodule (n = 51), biopsy of infiltrate (n = 14), excision or biopsy mediastinal mass (n = 12), decortication of empyema (n = 16), pleurodesis and bleb excision for pneumothorax (n = 5), pleurolysis for P32 administration (n = 3), esophageal myotomy (n = 2), and thymectomy (n = 1). In 6 children a contralateral thoracic procedure was performed along with VATS (3 VATS, 3 thoracotomies). Secondary VATS was performed in 20 after prior thoracic procedures. Results: VATS was efficacious for diagnostic or therapeutic purposes in 93 cases. Overall, 11 (11%) VATS required conversion to open thoracotomy. Average length of thoracostomy tube drainage (CTD) was 2.2 days, and average length of stay (LOS) was 3.7 days. Complications included prolonged air leak (>7 days) in 3 (2 empyema, 1 nodule). Two children with malignancy and pulmonary infiltrates died within 30 days of progressive respiratory failure. There were no bleeding complications or deaths related to VATS. Conclusions: VATS is a safe and effective primary and secondary procedure in children resulting in a short length of CTD and LOS. Duration of CTD and LOS are prolonged if empyema is associated with a bronchopleural fistula, and VATS may not be of value in this setting.

Original languageEnglish
Pages (from-to)134-138
Number of pages5
JournalJournal of Pediatric Surgery
Volume35
Issue number1
StatePublished - 2000

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Video-Assisted Thoracic Surgery
Empyema
Length of Stay
Thoracotomy
Thorax
Thoracostomy
Pleurodesis
Biopsy
Lung
Thymectomy
Pneumothorax
Blister
Respiratory Insufficiency
Fistula
Drainage

Keywords

  • Thoracoscopy
  • Video-assisted thoracic surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Rescorla, F., West, K. W., Gingalewski, C. A., Engum, S. A., Scherer, L. R., & Grosfeld, J. L. (2000). Efficacy of primary and secondary video-assisted thoracic surgery in children. Journal of Pediatric Surgery, 35(1), 134-138.

Efficacy of primary and secondary video-assisted thoracic surgery in children. / Rescorla, Frederick; West, Karen W.; Gingalewski, Cynthia A.; Engum, Scott A.; Scherer, L. R.; Grosfeld, Jay L.

In: Journal of Pediatric Surgery, Vol. 35, No. 1, 2000, p. 134-138.

Research output: Contribution to journalArticle

Rescorla, F, West, KW, Gingalewski, CA, Engum, SA, Scherer, LR & Grosfeld, JL 2000, 'Efficacy of primary and secondary video-assisted thoracic surgery in children', Journal of Pediatric Surgery, vol. 35, no. 1, pp. 134-138.
Rescorla F, West KW, Gingalewski CA, Engum SA, Scherer LR, Grosfeld JL. Efficacy of primary and secondary video-assisted thoracic surgery in children. Journal of Pediatric Surgery. 2000;35(1):134-138.
Rescorla, Frederick ; West, Karen W. ; Gingalewski, Cynthia A. ; Engum, Scott A. ; Scherer, L. R. ; Grosfeld, Jay L. / Efficacy of primary and secondary video-assisted thoracic surgery in children. In: Journal of Pediatric Surgery. 2000 ; Vol. 35, No. 1. pp. 134-138.
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