Subscribe to RSS
DOI: 10.1055/s-2005-865793
Georg Thieme Verlag KG Stuttgart, New York · Masson Editeur Paris
Thoracoscopic Surgery in Infants and Children
Publication History
Received: December 12, 2004
Accepted after Revision: January 5, 2005
Publication Date:
28 October 2005 (online)
![](https://www.thieme-connect.de/media/ejps/200505/lookinside/thumbnails/10.1055-s-2005-865793-1.jpg)
Abstract
Numerous investigators have shown that video-assisted thoracoscopic surgery (VATS) can be safely used for specific conditions of newborns, infants, and children. The technique has been postulated to be associated with a lower morbidity, shorter hospital stay, lower costs, and clinical results similar to those achieved by open surgery. The present article reviews the state of the art of VATS for thoracic conditions in children. Most authors focus on the feasibility of single procedures, and only a small number of reports deals with the feasibility in series with multiple types of procedures and larger numbers of patients. Therefore, systematic research on the advantages and limits of VATS in children remains mandatory.
Résumé
De nombreux investigateurs ont montré que la chirurgie thoracoscopique vidéo assistée (VATS) peut être utilisée de manière tout à fait sûre chez le nouveau-né, le nourrisson et l'enfant. La technique est considérée comme étant associée à un taux de morbidité bas, un séjour à l'hôpital plus court, un coût moins élevé et des résultats cliniques similaires à ceux obtenus par la chirurgie conventionnelle. Le présent article revoit l'état de l'art de VATS chez l'enfant. Beaucoup d'auteurs se focalisent sur la faisabilité d'une intervention et seulement un petit nombre rapportent la faisabilité et les différents types d'intervention sur un grand nombre de patients. C'est la raison pour laquelle une recherche systématique des avantages et des limites de VATS demeure obligatoire.
Resumen
Numerosos autores han mostrado que la cirugía toracoscópica videoasistida (VATS) puede ser usada con seguridad para algunas enfermedades de los recién nacidos, lactantes y niños. Esta técnica causa poca morbilidad,estancia hospitalaria corta y costo bajo con resultados clínicos similares a los obtenidos con la cirugía abierta. Este artículo revisa el estado del arte de la VATS para enfermedades torácicas en niños. La mayoría de los autores se concentran en la factibilidad de determinados procedimientos y solo unos pocos trabajos abordan estas operaciones variadas y números mayores de pacientes. Por lo tanto una investigación sistemática de la ventajas y límites de la VATS en niños sigue siendo necesaria.
Zusammenfassung
Zahlreiche Autoren belegten, dass die video-assistierte thorakoskopische Chirurgie bei Neugeborenen und Kindern unterschiedlichen Alters sicher anwendbar ist. Als Vorteile der Technik werden eine verminderte Morbidität, ein kürzerer Krankenhausaufenthalt und geringere Kosten bei einem der konventionellen Technik vergleichbaren funktionellen Resultat postuliert. Dieser Artikel gibt eine Übersicht über den „State of the Art“ der video-assistierten thorakoskopischen Chirurgie bei Kindern. Zumeist wird in vorliegenden Berichten die Machbarkeit einzelner Typen von Operationen an kleinen Serien untersucht. Nur wenige Analysen der Machbarkeit und Sicherheit wurden an größeren Serien mit multiplen Operationstypen durchgeführt. Für die Zukunft sind deshalb systematische Untersuchungen hinsichtlich der Vorteile und Limitierungen der video-assistierten thorakoskopischen Chirurgie bei Kindern zu fordern.
Key words
Thoracoscopy - child
Mots-clés
Thoracoscopie - enfant
Palabras clave
Toracoscopia - niños
Schlüsselwörter
Thorakoskopie - Kind
References
- 1 Adzick N S, Nance M L. Medical progress: pediatric surgery. New Engl J Med. 2000; 342 1651-1657
- 2 Albanese C T, Sydorak R M, Tsao K, Lee H. Thoracoscopic lobectomy for prenatally diagnosed lung lesions. J Pediatr Surg. 2003; 38 553-555
- 3 Alexiou C, Goyal A, Firmin R K, Hickey M S. Is open thoracotomy still a good treatment option for the management of empyema in children?. Ann Thorac Surg. 2003; 76 1854-1858
- 4 Allal H, Captier G, Lopez M, Forgues D, Galifer R-B. Evaluation of 142 consecutive laparoscopic fundoplications in children: effects of the learning curve and technical choice. J Pediatr Surg. 2001; 36 921-926
- 5 Bax N MA, van der Zee D C. Feasibility of thoracoscopic repair of esophageal atresia with distal fistula. J Pediatr Surg. 2002; 37 192-196
- 6 Bax N MA, van der Zee D C. Thoracoscopic repair of esophageal atresia with distal fistula. Surg Endosc. 2003; 17 1065-1067
- 7 Chang J HT, Rothenberg S S, Bealer J F, Hamby L A, Suadi R W. Endosurgery and the senior pediatric surgeon. J Pediatr Surg. 2001; 36 690-692
- 8 Cohen G, Hjortdal V, Ricci M. et al . Primary thoracoscopic treatment of empyema in children. Thorac Cardiovasc Surg. 2003; 125 79-83
- 9 Gates R L, Caniano D A, Hayes J R, Arca M J. Does VATS provide optimal treatment of empyema in children? A systematic review. J Pediatr Surg. 2004; 39 381-386
- 10 Hollands C M, Dixey L N, Torma M J. Technical assessment of porcine enteroenterostomy performed with ZEUSTM robotic technology. J Pediatr Surg. 2001; 36 1231-1233
- 11 International Pediatric Endosurgery Group (IPEG) .Guidelines for surgical treatment of empyema and related pleural diseases. Los Angeles; IPEG 2002
- 12 Klena J W, Cameron B H, Langer J C. et al . Timing of video-assisted thoracoscopic debridement for pediatric empyema. Am Coll Surg. 1998; 187 404-408
- 13 Langer D, Byhahn C, Markus B H, Heller K, Westphal K. Total endoscopic Nissen fundoplication with the robotic device “da Vinci” in children. Hemodynamics, gas exchange, and anesthetic management. Anaesth. 2001; 50 271-275
- 14 Liu D C, Flattmann G J, Karam M T, Siegrist B I, Loe W A, Hill C B. Laparoscopic fundoplication in children with previous abdominal surgery. J Pediatr Surg. 2000; 35 334-337
- 15 McConnell P I, Feola G P, Meyers R L. Methylene blue-stained autologous blood for needle localization and thoracoscopic resection of deep pulmonary nodules. J Pediatr Surg. 2002; 37 1729-1731
- 16 Marescaux J, Smith M K, Folscher D. et al . Telerobotic laparoscopic cholecystectomy: initial clinical experience with 25 patients. Ann Surg. 2001; 234 1-7
- 17 Meakins J L. Innovation in surgery: the rules of evidence. Am J Surg. 2002; 183 399-405
- 18 Osugi H, Takemura M, Higashino M. et al . Learning curve of video-assisted thoracoscopic esophagectomy and extensive lymphadenectomy for squamous cell cancer of thoracic esophagus and results. Surg Endosc. 2003; 17 515-519
- 19 Partrick D A, Bensard D D, Teitelbaum D H. et al . Successful thoracoscopic lung biopsy in children utilizing preoperative CT-guided localization. J Pediatr Surg. 2002; 37 970-973
- 20 Partrick D A, Rothenberg S S. Thoracoscopic resection of mediastinal masses in infants and children: an evaluation of technique and results. J Pediatr Surg. 2001; 35 1165-1167
- 21 Rescorla F J, West K W, Gingalewski C A, Engum S A, Scherer III L R, Grosfeld J L. Efficacy of primary and secondary video-assisted thoracic surgery in children. J Pediatr Surg. 2000; 35 134-138
-
22 Rodgers B M.
Thoracoscopy. Gans S Pediatric Endoscopy. New York; Grune & Stratton 1983: 139-150 - 23 Rodgers B M, Moazam F, Talbert J L. Thoracoscopy. Early diagnosis of interstitial pneumonitis in the immunologically suppressed child. Chest. 1979; 75 126-130
- 24 Rothenberg S S. Thoracoscopic lung resection in children. J Pediatr Surg. 2000; 35 271-275
- 25 Rothenberg S S. Experience with thoracoscopic lobectomy in infants und children. J Pediatr Surg. 2003; 38 102-104
- 26 Rothenberg S S. Thoracoscopic repair of tracheoesopageal fistula in a newborn infant. Pediatr Endosurg Innov Tech. 2000; 4 289-294
- 27 Rothenberg S S. Thoracoscopic repair of tracheoesophageal fistula in newborn. J Pediatr Surg. 2002; 37 869-872
- 28 Sartorelli K H, Partrick D, Meagher Jr D P. Port-site recurrence after thoracoscopic resection of pulmonary metastasis owing to osteogenic sarcoma. J Pediatr Surg. 1996; 31 1443-1444
- 29 Smith T J, Rothenberg S S, Brooks M. et al . Thoracoscopic surgery in childhood cancer. J Pediatr Kematol Oncol. 2002; 24 429-435
- 30 Tantoco J, Rossmann J, Dixey L. et al . Minimal access extrapleural esophagoesophagostomy. J Pediatr Surg. 2004; 39 855-858
- 31 Ure B M, Jesch N K, Sümpelmann R, Nustede R. Thoracoscopic resection of intra- and extrapulmonary sequestration in the first three months of life. J Pediatr Surg. 2005; in press
- 32 Waldhausen J HT, Tapper D, Sawin R S. Minimally invasive surgery and clinical decision-making for pediatric malignancy. Surg Endosc. 2000; 14 250-253
- 33 Waller D A. Video-assisted thoracoscopic surgery for spontaneous pneumothorax - a 7-year learning experience. Ann R Coll Surg Engl. 1999; 81 387-392
- 34 Yim A P, Lin J, Chan A T. et al . Video-assisted thoracoscopic wedge resections of pulmonary metastatic osteosarcoma: should it be performed?. Aust N Z J Surg. 1995; 65 737-739
Prof. Dr. Benno M. Ure
Department of Pediatric Surgery
Hannover Medical University
Carl-Neuberg-Straße 1
30625 Hannover
Germany
Email: ure.benno@mh-hannover.de