Present day concepts of thoracoscopy as a modality in pediatric cancer management.

Recent improvements in video imaging and instrumentation have encouraged a wider use of thoracoscopy as a modality for diagnostic procedures. Its utility for resection is still being reviewed. To assess the utility, diagnostic accuracy, and morbidity of thoracoscopy in children with cancer, we reviewed the experience at our institution. Between January 1991 and July 1995 sixty-four (64) procedures were performed either to diagnose pulmonary nodules of indeterminate origin (n = 42) or mediastinal masses (n = 11) or to evaluate pulmonary infiltrates in leukemia (n = 11). Thoracoscopy yielded a successful diagnosis in 90% of the cases. Conversion to open thoracotomy was necessary in 11 patients. Thoracoscopy in the management of children with cancer is useful for staging, obtaining diagnostic tissue, and is associated with a low morbidity.