Thoracoscopic lobectomy in infants and children / 中华胸心血管外科杂志

ABSTRACT

Objective Retrospectively analysis of our hospital thoracoscopic lobectomy cases in infants and children.This study evaluates the safety and efficacy of thoracoscopic lobectomy in infants and children.Methods Retrospective analysis of our hospital from April 2015 to August 2016,50 consecutive patients were plans to implement thoracoscopic lobectomy,excluding extralobar isolated,lung bullae,lung biopsies.35 males and 15 females,aged 2 months and 13 years,the average (5.94 ±3.94) years,3.25-59.00 kg body weight,average(22.15 ± 12.54) kg.11 cases of prenatal ultrasound to confirm.21 cases have a history of recurrent pneumonia.3 patients had a history of hemoptysis,are leaf-type isolation within the lung.Results 50 patients were successful in 46 cases by thoracoscopic surgery,4 patients underwent thoracotomy,transit rate of 8％.Transfer 4 cases,2 cases of left upper lobe,13 year-old and 15 year old children,preoperative recurrent pneumonia,pleural adhesions.1 case of right lower lobe,right lower pulmonary artery surgery damage the basal segments,bleeding.1 case of left lower lobe,the upper and lower leaf division stunted.VATS 40-300 minutes,an average of 120 minutes.There was no operative mortality,postoperative bleeding reoperation case who,as a transit cases thoracotomy.Lesion distribution right upper lobe in 5 cases,1ease of right middle lower,19 cases of right lower lobe,left upper lobe in 7 cases,18 cases of left lower lobe.Histological examination showed bronchial pulmonary cyst in 4 cases,leaf-type isolation within the lung in 15 cases,cystic adenomatoid malformation in 30 cases(type I 17 eases,type Ⅱ 13 cases).Indwelling chest tube after 2-3 days in hospital after 5-10 days,an average of 7 days.Postoperative follow-up 1-12 months,no recurrence and thoracic collapse,the remaining lung well compensated.Conclusion VATS lobectomy with less trauma,quicker recovery after surgery.However,due to the small chest in children,one lung difficulties,thoracoscopic operation requires a longer learning curve.Preoperative recurrent infections,pleural adhesions,fissure dysplasia will increase the rate of conversion to open.