Uniportal video-assisted thoracic surgery in a pediatric hospital: early results and review of the literature

Ugolini, S ORCID: https://orcid.org/0000-0001-7150-6082, Coletta, R ORCID: https://orcid.org/0000-0003-3878-1415, Lo Piccolo, R, Dell'Otto, F, Voltolini, L, Gonfiotti, A and Morabito, A 2022, 'Uniportal video-assisted thoracic surgery in a pediatric hospital: early results and review of the literature' , Journal of Laparoendoscopic & Advanced Surgical Techniques, 32 (6) , pp. 713-720.

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Abstract

Background: Uniportal video-assisted thoracic surgery (U-VATS) is an implemented technique in adult surgery that may aid to extend offer the benefits of thoracoscopy to a wide number of pediatric patients. Materials and Methods: Consecutive cases treated between July 2019 and July 2021 were retrospectively analyzed. Simultaneously, a MEDLINE systematic search was conducted. Results: Twelve patients (median age 13 years, median weight 44.5 kg) underwent 4 major procedures (n = 2 lobectomy, n = 2 segmentectomy) and 11 minor procedures (n = 1 bronchogenic cyst resection, n = 4 apical wedge resections and pleurodesis for pneumothorax, n = 4 wedge resections for lung nodules, and n = 2 debridement for empyema). The median observed operative time was 77 minutes. We recorded one conversion to biportal VATS. No intraoperative complications or 30-day morbidity–mortality was reported. A rate of 40% adverse postoperative events was observed (Clavien–Dindo grade I-IVa). Visual analog scale for postoperative pain recorded a median value of 0 on days 1, 2, and 3. The systematic review provided 15 full-text articles reporting 76 pediatric interventions (4 major and 72 minor procedures); among them, 1 biportal conversion, 3 mild postoperative complications, and 1 redo surgery are presented. Conclusions: As emerged from the literature review, U-VATS remains scarcely adopted by pediatric surgeons. Its feasibility is supported by the four reported major lung resections plus the four cases added on by our series. Thanks to a more rapid learning curve over conventional VATS, the uniportal technique could be accessible to a wider number of centers.

Item Type: Article
Schools: Schools > School of Health and Society
Journal or Publication Title: Journal of Laparoendoscopic & Advanced Surgical Techniques
Publisher: Mary Ann Liebert
ISSN: 1092-6429
SWORD Depositor: Publications Router
Depositing User: Publications Router
Date Deposited: 02 Sep 2022 09:35
Last Modified: 02 Sep 2022 09:35
URI: https://usir.salford.ac.uk/id/eprint/64150

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