Purpose: Video-assisted thoracoscopic surgical (VATS) technique for resection of cystic lung disease (CLD) may offer some advantages when compared with thoracotomy in children. From September 1999 to August 2004, 6 pe...Purpose: Video-assisted thoracoscopic surgical (VATS) technique for resection of cystic lung disease (CLD) may offer some advantages when compared with thoracotomy in children. From September 1999 to August 2004, 6 pediatric patients underwent VATS for CLD. Patients were chosen for VATS based upon surgeon’s choice. Data are expressed as mean ±SD. The Children’s Healthcare of Atlanta institutional review board approved this study. Results: The types of lesions included congenital cystic adenomatoid malformations (n = 1), extrapulmonary sequestrations (n = 3), congenital lobar emphysema (n = 1), and bronchogenic cyst (n = 1). The extent of resection included lobectomy (n = 2) and excision (n = 4). Age and weight were 11.8 ±18 months (range 6 days to 4 years) and 7.5 ±3.6 (range 4.0-14.0) kg, respectively. Operating time was 103 ±70 (range 38-223) minutes. Chest tube duration was 1.2 ±0.8 (range 0-2) days. Morphine use on the first postoperative day was 0.2±0.3(range 0.05-0.20)mg/kg. Length of stay was 2.5±1.9 (range 1-6) days. There were no conversions to thoracotomy and no complications. Conclusion: VATS technique appears to be a safe and effective technique in managing CLD in children of all ages. More patients, however, need to be studied.展开更多
Background:Video-assisted transumbilical appendectomy (VATA) is a combination of laparoscopic and open techniques and is not widely used in children. We are reporting our most recent experience with this technique. Me...Background:Video-assisted transumbilical appendectomy (VATA) is a combination of laparoscopic and open techniques and is not widely used in children. We are reporting our most recent experience with this technique. Methods:After the institutional review board approval,the charts of patients who underwent VATA between December 2003 and October 2004 were retrospectively reviewed. All children presenting with a preoperative diagnosis of appendicitis were candidates. A 10-mm trocar was placed in the umbilicus. An operating laparoscope was used for mobilizing the appendix. The appendix was delivered through the umbilicus. A standard extracorporeal appendectomy was performed. The umbilical ring was closed and the wound irrigated. Demographic and outcome data were collected and is presented as mean ± SD. Results:Sixty-one males and 50 females underwent VATA (n = 111). Age and weight were 11 ± 3.2 years and 49 ± 22 kg,respectively. Six patients had previous abdominal surgery. Operative time was 36 ± 24 minutes (range,9-140 minutes). An additional trocar was placed in 2 patients,and 2 patients were converted to open. Five patients had additional procedures. Appendicitis was classified intraoperatively as acute (n=44),suppurative (n=5),gangrenous (n=8),ruptured (n=30),appendiceal colic (n =13),and other (n=11). Preoperative antibiotics were given to 95 patients and were continued in 35 patients postoperatively. Length of stay was 1.8± 1.7 days (range,1-11 days). Length of follow-up was 13 ± 6.3 days (n =90). Complications included intra-abdominal abscess (n =1) and wound infection (n=7) . Conclusions:Video-assisted transumbilical appendectomy minimizes equipment needs,thus,potentially reducing cost. Simple and complex appendectomies can be performed even if the patient has had previous abdominal surgery. Our complication rate was low,and our operating times and length of stay were short. Video-assisted transumbilical appendectomy is a safe and effective technique in children and can be used in lieu of the 3-trocar laparoscopic technique.展开更多
文摘Purpose: Video-assisted thoracoscopic surgical (VATS) technique for resection of cystic lung disease (CLD) may offer some advantages when compared with thoracotomy in children. From September 1999 to August 2004, 6 pediatric patients underwent VATS for CLD. Patients were chosen for VATS based upon surgeon’s choice. Data are expressed as mean ±SD. The Children’s Healthcare of Atlanta institutional review board approved this study. Results: The types of lesions included congenital cystic adenomatoid malformations (n = 1), extrapulmonary sequestrations (n = 3), congenital lobar emphysema (n = 1), and bronchogenic cyst (n = 1). The extent of resection included lobectomy (n = 2) and excision (n = 4). Age and weight were 11.8 ±18 months (range 6 days to 4 years) and 7.5 ±3.6 (range 4.0-14.0) kg, respectively. Operating time was 103 ±70 (range 38-223) minutes. Chest tube duration was 1.2 ±0.8 (range 0-2) days. Morphine use on the first postoperative day was 0.2±0.3(range 0.05-0.20)mg/kg. Length of stay was 2.5±1.9 (range 1-6) days. There were no conversions to thoracotomy and no complications. Conclusion: VATS technique appears to be a safe and effective technique in managing CLD in children of all ages. More patients, however, need to be studied.
文摘Background:Video-assisted transumbilical appendectomy (VATA) is a combination of laparoscopic and open techniques and is not widely used in children. We are reporting our most recent experience with this technique. Methods:After the institutional review board approval,the charts of patients who underwent VATA between December 2003 and October 2004 were retrospectively reviewed. All children presenting with a preoperative diagnosis of appendicitis were candidates. A 10-mm trocar was placed in the umbilicus. An operating laparoscope was used for mobilizing the appendix. The appendix was delivered through the umbilicus. A standard extracorporeal appendectomy was performed. The umbilical ring was closed and the wound irrigated. Demographic and outcome data were collected and is presented as mean ± SD. Results:Sixty-one males and 50 females underwent VATA (n = 111). Age and weight were 11 ± 3.2 years and 49 ± 22 kg,respectively. Six patients had previous abdominal surgery. Operative time was 36 ± 24 minutes (range,9-140 minutes). An additional trocar was placed in 2 patients,and 2 patients were converted to open. Five patients had additional procedures. Appendicitis was classified intraoperatively as acute (n=44),suppurative (n=5),gangrenous (n=8),ruptured (n=30),appendiceal colic (n =13),and other (n=11). Preoperative antibiotics were given to 95 patients and were continued in 35 patients postoperatively. Length of stay was 1.8± 1.7 days (range,1-11 days). Length of follow-up was 13 ± 6.3 days (n =90). Complications included intra-abdominal abscess (n =1) and wound infection (n=7) . Conclusions:Video-assisted transumbilical appendectomy minimizes equipment needs,thus,potentially reducing cost. Simple and complex appendectomies can be performed even if the patient has had previous abdominal surgery. Our complication rate was low,and our operating times and length of stay were short. Video-assisted transumbilical appendectomy is a safe and effective technique in children and can be used in lieu of the 3-trocar laparoscopic technique.
