Two Decades of Experience with Thoracoscopic Lobectomy in Infants and Children: Standardizing Techniques for Advanced Thoracoscopic Surgery
Two Decades of Experience with Thoracoscopic Lobectomy in Infants and Children: Standardizing Techniques for Advanced Thoracoscopic Surgery
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DOI：
10.1089/lap.2014.0350
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发表时间：
2015-05-01
影响因子：
1.3
通讯作者：
Stylianos, Steven
中科院分区：
文献类型：
--
作者：
Rothenberg, Steven S.;Middlesworth, William;Stylianos, Steven
目的：本研究评估的安全性和有效性胸腔镜肺叶切除术在婴幼儿和children.Materials和方法：从1994年1月至2013年11月，347例患者进行了电视胸腔镜肺叶切除术在两个机构。所有手术均由一名外科医生或在其直接指导下进行。患者年龄范围为1天至18岁，体重范围为2.8至78 kg。术前诊断包括肺隔离症/先天性肺气道畸形（n=306）、严重支气管扩张（n=24）、先天性肺叶气肿（n=13）和恶性肿瘤（n=4）。手术时间为35分钟至240分钟（平均115分钟）。当实习生是主刀医生时，平均手术时间为160分钟。上叶切除81例，中叶切除25例，下叶切除241例。有4例术中并发症（1.1%）需要转为开胸手术。术后并发症发生率为3.3%，3例患者因长期漏气需要再次探查。住院时间（LOS）范围为1至16天（平均）。患者
Objectives: This study evaluates the safety and efficacy of thoracoscopic lobectomy in infants and children.Materials and Methods: From January 1994 to November 2013, 347 patients underwent video-assisted thoracoscopic lobe resection at two institutions. All procedures were performed by or under the direct guidance of a single surgeon. Patients' ages ranged from 1 day to 18 years, and weights ranged from 2.8 to 78 kg. Preoperative diagnosis included sequestration/congenital pulmonary airway malformation (n=306), severe bronchiectasis (n=24), congenital lobar emphysema (n=13), and malignancy (n=4).Results: Of the 347 procedures, 342 were completed thoracoscopically. Operative times ranged from 35 minutes to 240 minutes (average, 115 minutes). Average operative time when a trainee was the primary surgeon was 160 minutes. There were 81 upper, 25 middle, and 241 lower lobe resections. There were four intraoperative complications (1.1%) requiring conversion to an open thoracotomy. The postoperative complication rate was 3.3%, and 3 patients required re-exploration for a prolonged air leak. Hospital length of stay (LOS) ranged from 1 to 16 days (average). In patients