Çocuklarda Torakoskopik Lobektomi ve Segmentektomi

Year 2020, Volume: 73 Issue: 2, 149 - 154, 21.07.2020

Gülnur Göllü

Abstract

Project Number

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Thoracoscopic Lobectomy and Segmentectomy in Children

Abstract

Objectives: In the last decade, video-assisted thoracoscopic surgery (VATS) is gaining broad popularity in pediatric surgery. The purpose of this study is to analyze the clinical and histopathological results of VATS in pediatric population in a minimum 1-year follow-up period.

Materials and Methods: All patients undergoing an elective lobectomy or segmentectomy with VATS were enrolled for the study. Medical charts of the enrolled patients were retrospectively evaluated and the data of the patients who met the inclusion criteria were extracted for the final analysis. Patients’ demographics including gender and age, indications for VATS and past surgical history, preoperative investigations, comorbidities, intraoperative findings, operative data, postoperative course including any morbidity and mortality were recorded.

Results: There were 26 patients (13 males, 13 females). The main indication for VATS was congenital pulmonary airway malformation (10 patients). There were only two segmentectomies. The remaining 24 patients had undergone lobectomies. Only two patients had multi-lobectomies. In four patients, conversion to thoracotomy was required because of bleeding and inadequate exposure. The mean operation time was 107 mins. Chest tube was placed in all of the patients and removed between the postoperative 2nd and 10th days (median=4 days) and the average discharge time was 5.7 days (3-12 days).

Conclusion: VATS is a safe and effective surgical procedure not only for the adults but also for the pediatric population. It has low complication rates with faster recovery time especially for the pediatric cases that have malignancies.

Keywords

Child, Lobectomy, Minimal Invasive Surgery, Segmentectomy, Thoracoscopy

Ethical Statement

The protocol of the study was approved by the institutional review board of our institution (12-716-17).

Supporting Institution

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Project Number

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Thanks

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References

• 1. Baysungur V, Tezel C, Okur E et al. Quality of life assessment six months after lobectomy for lung cancer: video-assisted thoracoscopic surgery versus thoracotomy. Turkish Journal of Thoracic and Cardiovascular Surgery. 2010;19:207-212.
• 2. Gilbert JC, Powell DM, Hartman GE, et al. Video-assisted thoracic surgery (VATS) for children with pulmonary metastases from osteosarcoma. Ann Surg Oncol. 1996;3:539-542.
• 3. Yagmurlu A, Aktug T. Video-assisted thoracoscopic surgery (VATS) in the management of complicated pneumonia in children. J Pediatr Surg. 2001;36:1875.
• 4. Rodgers BM, Moulder PV, DeLaney A. Thoracoscopy: new method of early diagnosis of cardiac herniation. J Thorac Cardiovasc Surg. 1979;78:623-625.
• 5. Liu HP, Chang CH, Lin PJ, et al. Thoracoscopic management of effusive pericardial disease: indications and technique. Ann Thorac Surg. 1994;58:1695-1697.
• 6. Kogut KA, Bufo AJ, Rothenberg SS, et al. Thoracoscopic thymectomy for myasthenia gravis in children. J Pediatr Surg. 2000;35:1576-1577.
• 7. Kraus DH, Saenz NC, Gollamudi S, et al. Pediatric rhabdomyosarcoma of the head and neck. Am J Surg. 1997;174:556-560.
• 8. Koizumi K, Tanaka S, Haraguchi S, et al. Lobectomy by video-assisted thoracic surgery for primary lung cancer: experiences based on provisional indications. Surg Today. 1998;28:36-40.
• 9. Spurbeck WW, Davidoff AM, Lobe TE, et al. Minimally invasive surgery in pediatric cancer patients. Ann Surg Oncol. 2004;11:340-343.
• 10. Crisci R, Droghetti A, Migliore M, et al. Video-assisted thoracic lobectomy for lung cancer in Italy: the ‘VATS Group’ Project. Future Oncol. 2016;12:9- 11.
• 11. Jing X, Lin Y, Zhang B, et al. Video-assisted thoracoscopic lobectomy mitigates adverse oncological effects of delayed adjuvant chemotherapy for nonsmall cell lung cancer patients. J BUON. 2016;21:1524-1529.
• 12. Samancilar O, Akçam TI, Kaya SO, et al. Video-assisted thoracoscopic surgery (VATS) right upper lobectomy for non-small-cell lung cancer with an azygos lobe. Kardiochir Torakochirurgia Pol. 2016;13:373-374.
• 13. Daniels LJ, Balderson SS, Onaitis MW, et al.Thoracoscopic lobectomy: a safe and effective strategy for patients with stage I lung cancer. Ann Thorac Surg. 2002;74:860-864.
• 14. Peng J, An S, Wang HP, et al. Video-assisted thoracoscopic surgery lobectomy for lung cancer versus thoracotomy: a less decrease in sVEGFR2 level after surgery. J Thorac Dis. 2016;8:323-328.
• 15. Polastri M, Dell’Amore A, Dolci G, et al. Dyspnea and Fatigue Following Videoassisted Thoracic Surgery for Pulmonary Lobectomy: Measuring Scales to Optimize the Allocation of Resources. Chin Med J (Engl). 2016;129:2139- 2140.
• 16. Amore D, Curcio C. Steps in the development of a VATS lobectomy program. J Vis Surg. 2017;3:104.
• 17. Sawant A, Mankar H, Chatterjee A, et al. VATS Versus Open Lobectomy: Need for a Prospective Trial. Ann Thorac Surg. 2017;103:690-691.
• 18. Tcherveniakov P, Bogdan C, Chaudhuri N. Crossing the bridge to VATS lobectomy. Ann R Coll Surg Engl. 2017;99:650-652.
• 19. Alam NZ, Flores RM. Extended video-assisted thoracic surgery (VATS) lobectomy. Minerva Chir. 2016;71:67-71.
• 20. Kamel MK, Nasar A, Stiles BM, et al. Video-Assisted Thoracoscopic Lobectomy Is the Preferred Approach Following Induction Chemotherapy. J Laparoendosc Adv Surg Tech A. 2017;27:495-500.
• 21. Sihoe AD. Uniportal video-assisted thoracic (VATS) lobectomy. Ann Cardiothorac Surg. 2016;5:133-144.
• 22. Albanese CT, Sydorak RM, Tsao K, et al. Thoracoscopic lobectomy for prenatally diagnosed lung lesions. J Pediatr Surg. 2003;38:553-555.
• 23. Rothenberg SS. Experience with thoracoscopic lobectomy in infants and children. J Pediatr Surg. 2003;38:102-104.
• 24. Seong YW, Kang CH, Kim JT, et al. Video-assisted thoracoscopic lobectomy in children: safety, efficacy, and risk factors for conversion to thoracotomy. Ann Thorac Surg. 2013;95:1236-1242.
• 25. Blasberg JD, Seder CW, Leverson G, et al. Video-Assisted Thoracoscopic Lobectomy for Lung Cancer: Current Practice Patterns and Predictors of Adoption. Ann Thorac Surg. 2016;102:1854-1862.
• 26. Gazala S, Hunt I, Valji A, et al. A method of assessing reasons for conversion during video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg. 2011;12:962-964.
• 27. Rothenberg SS, Middlesworth W, Kadennhe-Chiweshe A, et al. Two decades of experience with thoracoscopic lobectomy in infants and children: standardizing techniques for advanced thoracoscopic surgery. J Laparoendosc Adv Surg Tech A. 2015;25:423-438.
• 28. Park BJ. Reply to Letter: “Long-term Survival Based on the Surgical Approach to Lobectomy for Clinical Stage I Nonsmall Cell Lung Cancer: Comparison of Robotic, Video-assisted Thoracic Surgery, and Thoracotomy Lobectomy”. Ann Surg. 2018;267: e34-e35.
• 29. Smith TJ, Rothenberg SS, Brooks M, et al. Thoracoscopic surgery in childhood cancer. J Pediatr Hematol Oncol. 2002;24:429-435.