[Thoracoscopic lobectomy in pediatrics. Our experience and new treatment perspectives].

OBJECTIVES

Pulmonary malformations in the child are a wide clinical and pathologycal spectrum. The congenital cystic adenomatoid malformation and the pulmonary sequestration both produce many symptoms, from the asymptomatic to the most complicated, and its management remains controversial. Moreover, in the last years many new publications show that this surgery can be perfectly accomplished with the thoracoscopic approach as an alternative to the tradicional open surgery. In this paper we analyse our experience in performing lobectomies with thoracoscopy. This technique shows to be safe and has less complications than tradicional thoracotomy.

METHODS

During the period 2004-2008 lobectomies were performed in six patiens, with ages between one week and fifteen years. The diagnostics where CAM in four cases, associated to PS in one case; broncogenic cyst in none case, and cavitary pulomonar aspergilloma in one case.

RESULTS

Five inferior and one median lobectomies were done. In two cases the patients had no symptoms before intervention, the other four cases were asymptomatic. In all cases the toracoscopy was performed with 3 or 4 ports of 3-5 mm. No mini-thoracotomy was done in any case. There were nor intraoperatory neither postoperatory complications. In all patients were placed two thoracic drainages, being retired 3 to 4 days later. All patients, except one, remained five days in hospital.

CONCLUSIONS

In this work, thoracoscopic lobectomy is confirmed as safe technique and with less complications and morbidity than the open lobectomy. Therefore, we suggest new posible aplications.